[Percutaneous ethanol injection (PEI) for small hepatocellular carcinoma--study on its therapeutic effect and...

Percutaneous ethanol injection (PEI) was performed on 183 tumors in 147 patients with small hepatocellular carcinoma (HCC), of no larger than 3 cm in size and less than three in number, during 9 years and 4 months between August 1983 and December 1992. The 1-, 3- and 5-year survival rates of all 147 patients calculated by the Kaplan-Meier method were 96.3%, 62.5% and 40.7% respectively. Multivariate analysis (Cox's proportional hazard model) demonstrated that the most significant factor contributing to the prognosis of the patients was the severity of liver dysfunction (clinical stage) before treatment. Recurrence was seen in different areas of the liver from the original lesion in 26.9% in one year and 61.5% in three years. Multivariate analysis demonstrated that the most significant factor contributing to the recurrence was the number of tumors before treatment. Regrowth of the original tumor occurred in two patients (1.4%). There was no serious complication due to PEI. To evaluate the therapeutic effect of PEI, contrast-enhanced CT with intravenous bolus injection was considered to be indispensable. We conclude that PEI can be indicated in most patients with small HCC and is also effective.