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Percutaneous ethanol injection for liver metastases.
Mateusz J Swierz1, Dawid Storman2, Robert P Riemsma3
1Jagiellonian University Medical College, Department of Hygiene and Dietetics, Systematic Reviews Unit, Krakow, Poland.
The Cochrane Database of Systematic Reviews
|February 5, 2020
Summary
Percutaneous ethanol injection (PEI) combined with transcatheter arterial chemoembolisation (TACE) may improve survival and reduce recurrence in liver metastases. However, evidence is very limited, and more research is needed to confirm these findings.
Area of Science:
- Hepatobiliary Malignancies
- Interventional Oncology
- Tumor Ablation Techniques
Background:
- Liver metastases are common, often originating from colorectal cancer.
- Surgical resection (R0) is not always feasible for liver metastases.
- Percutaneous ethanol injection (PEI) is an ablation technique causing tumor cell necrosis.
Purpose of the Study:
- To evaluate the efficacy and safety of percutaneous ethanol injection (PEI) for liver metastases.
- To compare PEI against no intervention, other ablation methods, and systemic treatments.
Main Methods:
- Systematic search of multiple databases and clinical trial registries up to September 2019.
- Inclusion of randomized clinical trials assessing PEI for liver metastases.
- Data extraction and risk of bias assessment by two independent reviewers.
Main Results:
- One trial (48 participants) compared PEI + TACE vs. TACE alone for liver metastases.
- PEI + TACE showed a trend towards improved 3-year survival (64% vs. 47.8%) and reduced local recurrence (16% vs. 39.1%).
- Evidence quality was very low due to one small trial with high risk of bias.
Conclusions:
- The effectiveness of adding PEI to TACE for liver metastases is uncertain due to very low-certainty evidence.
- Further high-quality randomized trials are needed to determine the role of PEI.
- No evidence was found for PEI compared to other interventions.
