Percutaneous ethanol injection of hepatic tumors: Single-session therapy with general anesthesia

T. Livraghi, S. Lazzaroni, S. Pellicano, S. Ravasi, G. Torzilli, C. Vettori

Research output: Contribution to journalArticle

Abstract

OBJECTIVE. We studied the feasibility and the effectiveness of percutaneous ethanol injection, performed with general anesthesia in a single session, for treating malignant hepatic lesions. SUBJECTS AND METHODS. We treated 30 patients with sonographically guided percutaneous injection of ethanol. Twenty had hepatocellular carcinoma and cirrhosis, and 10 had hepatic metastases, principally from colon cancer. The mean volume of ethanol injected was 57 ml (range, 6-165 ml). RESULTS. CT showed complete necrosis (up to 8.2 cm) in seven of 10 patients with encapsulated hepatocellular carcinoma and about 90% necrosis in the remaining three patients. In four of these patients, the α-fetoprotein level fell from more than 200 ng/ml to less than 20 ng/ml during treatment. In 10 patients with infiltrating hepatocellular carcinoma, about 70-90% necrosis was achieved; in six of these patients, the α-fetoprotein level, which had been more than 200 ng/ml, decreased during treatment. In the 10 patients with metastases, more than 50% necrosis was always achieved. Levels of carcinoembryonic antigen decreased after treatment in all patients. In three patients who had cirrhosis with superficial hepatocellular carcinoma, peritoneal hemorrhage occurred but did not require transfusion. CONCLUSION. Our results show that percutaneous injection of ethanol in a single session with general anesthesia is feasible and effective and has several advantages over multisession therapy. These include shorter treatment time and the ability to treat larger and more numerous lesions.

Original languageEnglish
Pages (from-to)1065-1069
Number of pages5
JournalAmerican Journal of Roentgenology
Volume161
Issue number5
Publication statusPublished - 1993

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General Anesthesia
Ethanol
Injections
Liver
Neoplasms
Hepatocellular Carcinoma
Necrosis
Fetal Proteins
Therapeutics
Fibrosis
Neoplasm Metastasis
Carcinoembryonic Antigen
Colonic Neoplasms
Hemorrhage

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Livraghi, T., Lazzaroni, S., Pellicano, S., Ravasi, S., Torzilli, G., & Vettori, C. (1993). Percutaneous ethanol injection of hepatic tumors: Single-session therapy with general anesthesia. American Journal of Roentgenology, 161(5), 1065-1069.

Percutaneous ethanol injection of hepatic tumors : Single-session therapy with general anesthesia. / Livraghi, T.; Lazzaroni, S.; Pellicano, S.; Ravasi, S.; Torzilli, G.; Vettori, C.

In: American Journal of Roentgenology, Vol. 161, No. 5, 1993, p. 1065-1069.

Research output: Contribution to journalArticle

Livraghi, T, Lazzaroni, S, Pellicano, S, Ravasi, S, Torzilli, G & Vettori, C 1993, 'Percutaneous ethanol injection of hepatic tumors: Single-session therapy with general anesthesia', American Journal of Roentgenology, vol. 161, no. 5, pp. 1065-1069.
Livraghi, T. ; Lazzaroni, S. ; Pellicano, S. ; Ravasi, S. ; Torzilli, G. ; Vettori, C. / Percutaneous ethanol injection of hepatic tumors : Single-session therapy with general anesthesia. In: American Journal of Roentgenology. 1993 ; Vol. 161, No. 5. pp. 1065-1069.
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AU - Livraghi, T.

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AU - Pellicano, S.

AU - Ravasi, S.

AU - Torzilli, G.

AU - Vettori, C.

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N2 - OBJECTIVE. We studied the feasibility and the effectiveness of percutaneous ethanol injection, performed with general anesthesia in a single session, for treating malignant hepatic lesions. SUBJECTS AND METHODS. We treated 30 patients with sonographically guided percutaneous injection of ethanol. Twenty had hepatocellular carcinoma and cirrhosis, and 10 had hepatic metastases, principally from colon cancer. The mean volume of ethanol injected was 57 ml (range, 6-165 ml). RESULTS. CT showed complete necrosis (up to 8.2 cm) in seven of 10 patients with encapsulated hepatocellular carcinoma and about 90% necrosis in the remaining three patients. In four of these patients, the α-fetoprotein level fell from more than 200 ng/ml to less than 20 ng/ml during treatment. In 10 patients with infiltrating hepatocellular carcinoma, about 70-90% necrosis was achieved; in six of these patients, the α-fetoprotein level, which had been more than 200 ng/ml, decreased during treatment. In the 10 patients with metastases, more than 50% necrosis was always achieved. Levels of carcinoembryonic antigen decreased after treatment in all patients. In three patients who had cirrhosis with superficial hepatocellular carcinoma, peritoneal hemorrhage occurred but did not require transfusion. CONCLUSION. Our results show that percutaneous injection of ethanol in a single session with general anesthesia is feasible and effective and has several advantages over multisession therapy. These include shorter treatment time and the ability to treat larger and more numerous lesions.

AB - OBJECTIVE. We studied the feasibility and the effectiveness of percutaneous ethanol injection, performed with general anesthesia in a single session, for treating malignant hepatic lesions. SUBJECTS AND METHODS. We treated 30 patients with sonographically guided percutaneous injection of ethanol. Twenty had hepatocellular carcinoma and cirrhosis, and 10 had hepatic metastases, principally from colon cancer. The mean volume of ethanol injected was 57 ml (range, 6-165 ml). RESULTS. CT showed complete necrosis (up to 8.2 cm) in seven of 10 patients with encapsulated hepatocellular carcinoma and about 90% necrosis in the remaining three patients. In four of these patients, the α-fetoprotein level fell from more than 200 ng/ml to less than 20 ng/ml during treatment. In 10 patients with infiltrating hepatocellular carcinoma, about 70-90% necrosis was achieved; in six of these patients, the α-fetoprotein level, which had been more than 200 ng/ml, decreased during treatment. In the 10 patients with metastases, more than 50% necrosis was always achieved. Levels of carcinoembryonic antigen decreased after treatment in all patients. In three patients who had cirrhosis with superficial hepatocellular carcinoma, peritoneal hemorrhage occurred but did not require transfusion. CONCLUSION. Our results show that percutaneous injection of ethanol in a single session with general anesthesia is feasible and effective and has several advantages over multisession therapy. These include shorter treatment time and the ability to treat larger and more numerous lesions.

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