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Annals of Oncology 14:1648-1653, 2003
© 2003 European Society for Medical Oncology

Original Paper

Sequential transarterial chemoembolization and percutaneous acetic acid injection therapy versus repeated percutaneous acetic acid injection for unresectable hepatocellular carcinoma: a prospective study

T.-I. Huo1,+, Y.-H. Huang1, J.-C. Wu1, J.-H. Chiang2, P.-C. Lee1, F.-Y. Chang1 and S.-D. Lee1

1 Department of Medicine, 2 Department of Radiology, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan, Republic of China

Received 14 May 2003; revised 11 June 2003; accepted 11 August 2003

Background:

Transarterial chemoembolization (TACE) and percutaneous acetic acid injection (PAI) are effective treatments for hepatocellular carcinoma (HCC). We have conducted a prospective study to compare the efficacy of sequential TACE and PAI (TACE-PAI) versus repeated PAI therapy for HCC.

Patients and methods:

A total of 108 HCC patients with tumor size <=5 cm were enrolled. Fifty-three patients were treated with TACE–PAI and 55 patients were treated with PAI alone.

Results:

Objective responses were achieved in 72 of 80 nodules (90%) in the TACE–PAI group compared with 51 of 62 nodules (82%) in the PAI group (P = 0.217) during 24 ± 10 months of follow-up. Patients in the TACE–PAI group had a significantly lower cumulative tumor recurrence rate from the treated nodule (P = 0.004) or newly developed tumor elsewhere in liver (P = 0.010). Complete tumor necrosis in large (3–5 cm) HCCs was more frequently encountered in the TACE–PAI group (64% versus 37%; P = 0.034). There was no significant survival difference between the two groups with small (<=3 cm) HCC (P = 0.569), whereas PAI therapy was an independent poor prognostic predictor [relative risk 3.0 (95% confidence interval 1.2–7.6); P = 0.017] in the large HCC group.

Conclusions:

Sequential therapy with TACE and PAI is superior to repeated PAI alone for patients with large HCC.

Key words: arterial embolization, hepatocellular carcinoma, liver cirrhosis, percutaneous acetic acid injection


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T.-I. Huo, Y.-H. Huang, J.-C. Wu, P.-C. Lee, F.-Y. Chang, and S.-D. Lee
Induction of complete tumor necrosis may reduce intrahepatic metastasis and prolong survival in patients with hepatocellular carcinoma undergoing locoregional therapy: a prospective study
Ann. Onc., May 1, 2004; 15(5): 775 - 780.
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