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Related Experiment Video

Updated: May 10, 2026

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Percutaneous ethanol injection for liver metastases.

Robert P Riemsma1, Malgorzata M Bala, Robert Wolff

  • 1Kleijnen Systematic Reviews Ltd, York,UK. rob@systematic-reviews.com.

The Cochrane Database of Systematic Reviews
|June 4, 2013
PubMed
Summary

Adding percutaneous ethanol injection (PEI) to transcatheter arterial chemoembolisation (TACE) for liver metastases showed larger tumour necrosis but no clear survival or local recurrence benefits. More research is needed to confirm PEI efficacy.

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Area of Science:

  • Hepatology
  • Oncology
  • Interventional Radiology

Background:

  • Liver metastases, particularly from colorectal carcinoma, are common and often fatal.
  • Percutaneous ethanol injection (PEI) is a method to destroy tumour cells through dehydration and necrosis.
  • Metastatic liver disease significantly impacts patient survival.

Purpose of the Study:

  • To evaluate the efficacy and safety of percutaneous ethanol injection (PEI) in patients with liver metastases.
  • To compare PEI with no intervention, other ablation techniques, or systemic treatments.
  • To assess the beneficial and harmful effects of PEI for liver metastases.

Main Methods:

  • A systematic search of multiple databases (Cochrane Hepato-Biliary Group, CENTRAL, MEDLINE, EMBASE, etc.) was conducted up to December 2012.

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  • Included were randomized clinical trials comparing PEI with other treatments or no intervention for liver metastases.
  • Data extraction and quality assessment were performed by two independent reviewers.

    • Main Results:

    • One trial involving 48 patients compared transcatheter arterial chemoembolisation (TACE) + PEI versus TACE alone.
    • The TACE + PEI group showed a trend towards better survival (92% at 1 year) and significantly reduced local recurrence (16%) compared to TACE alone (78.3% and 39.1%, respectively).
    • Tumour shrinkage was greater in the TACE + PEI group (66.2% vs. 48.4%), but no clear survival benefit was observed.

    Conclusions:

    • The addition of PEI to TACE for liver metastases did not demonstrate a clear survival or local recurrence benefit in this small trial.
    • Larger tumour necrosis was observed with the combined TACE + PEI treatment.
    • Further randomized trials are necessary to establish the role of PEI in managing liver metastases.