Percutaneous ethanol injection therapy for hepatocellular carcinoma. A histopathologic study

Area of Science:

• Hepatobiliary Medicine
• Interventional Oncology
• Surgical Pathology

Background:

• Hepatocellular carcinoma (HCC) presents a significant global health challenge.
• Percutaneous ethanol injection therapy (PEIT) is an established treatment modality for HCC.
• Optimizing PEIT techniques is crucial for improving patient outcomes.

Purpose of the Study:

• To histopathologically evaluate the efficacy of percutaneous ethanol injection therapy (PEIT) for hepatocellular carcinoma.
• To assess the impact of PEIT alone versus combined with transcatheter arterial embolization (TACE) on tumor necrosis.
• To identify factors influencing treatment success and refine PEIT methodology.

Main Methods:

• Histopathologic examination of 18 HCC cases post-PEIT.
• Analysis of treatment outcomes comparing PEIT alone (8 cases) and PEIT with TACE (10 cases).
• Evaluation of tumor necrosis, invasion, and surrounding liver parenchyma.

Main Results:

• Complete tumor necrosis observed in 13 cases; 90% necrosis in 4 cases; 70% necrosis in 1 case.
• PEIT demonstrated effectiveness against intercapsular, extracapsular, and vascular tumor invasions.
• Incomplete necrosis was associated with residual tumor nodules at the lesion periphery, suggesting the need for targeted peripheral ethanol delivery.

Conclusions:

• Percutaneous ethanol injection therapy is a valuable treatment for hepatocellular carcinoma, achieving high rates of tumor necrosis.
• PEIT appears effective in managing various tumor invasion types.
• Targeted ethanol injection into both the tumor center and periphery is recommended for maximizing therapeutic effect and potentially serving as a surgical alternative.