Skip to main content
SpringerLink
Log in
Book cover

Percutaneous Tumor Ablation in Medical Radiology pp 123–127Cite as

Percutaneous Alcohol Instillation

  • Chapter

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

Abstract

As yet there is no general consensus on a common rational therapeutic approach to hepatocellular carcinoma (HCC). Therefore, treatment strategies for HCC vary throughout the world due to geographical differences in the incidence and presentation of the disease and the treatment options available. Several treatment guidelines have been published by the European Association for the Study of the Liver (EASL) (Bruix et al. 2001), with the Barcelona Clinic Liver Cancer (BCLC) staging recommendation being the most accepted (Fig. 3.2.1) (Mor et al. 1998; Sala et al. 2004). It links tumoral stage with treatment strategy, and is aimed at incorporating an estimation of the prognosis and potential treatment advancements in a single unified proposal (Sala et al. 2004). According to these guidelines percutaneous alcohol instillation (PAI) has a place in the treatment strategy of HCC, generally as a second choice when surgical techniques are precluded, such as in patients with early-stage tumors; nevertheless, in some centers in Italy and Japan PAI is used as a first-line treatment option (Llovet et al. 2003).

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   89.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Arii S, Yamaoka Y, Futugawa S, Inoue K, Kobayashi K, Kojiro M, Makuuchi M, Nakamura Y, Okita K, Yamada R (2000) Results of surgical and nonsurgical treatment for smallsized hepatocellular carcinomas: a retrospective and nationwide survey in Japan. Hepatology 32:1224–1229

    Article  PubMed  CAS  Google Scholar 

  • Bruix J, Sherman M, Llovet JM, Beaugrand M, Lencioni R, Burroughs AK, Christensen E, Pagliaro L, Colombo M, Rodés J, for the EASL Panel of Experts on HCC (2001) Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL Conference. J Hepatol 35:421–430

    Article  PubMed  CAS  Google Scholar 

  • Di Stasi M, Buscarini L, Livraghi T, Giorgio A, Salmi A, De Sio I, Brunello F, Solmi L, Caturelli E, Magnolfi F, Caremani M, Filice C (1997) Percutaneous ethanol injection in the treatment of hepatocellular carcinoma. A multicenter survey of evaluation practices and complication rates. Scand J Gastroenterol 32:1168–1173

    PubMed  Google Scholar 

  • Ebara M, Okabe S, Kita K, Sugiura N, Fukuda H, Yoshikawa M, Kondo F, Saisho H (2005) Percutaneous ethanol injection for small hepatocellular carcinoma: therapeutic efficacy based on 20-year observation. J Hepatol 43:377–380

    Article  Google Scholar 

  • Huang GT, Lee PH, Tsang YM, Lai MY, Yang PM, Hu RH, Chen PJ, Kao JH, Sheu JC (2005) Percutaneous ethanol injection versus surgical resection for the treatment of small hepatocellular carcinoma: a prospective study. Ann Surg 242:36–42

    Article  PubMed  Google Scholar 

  • Ikeda M, Okada S, Ueno H, Okusaka T, Kuriyama H (2001) Radiofrequency ablation and percutaneous ethanol injection in patients with small hepatocellular carcinoma: a comparative study. Jpn J Clin Oncol 31:322–326

    Article  PubMed  CAS  Google Scholar 

  • Khan KN, Yatsuhashi H, Yamasaki K, Yamasaki M, Inoue O, Koga M, Yano M (2000) Prospective analysis of risk factors for early intrahepatic recurrence of hepatocellular carcinoma following ethanol injection. J Hepatol 32:269–278

    Article  PubMed  CAS  Google Scholar 

  • Koda M, Murawaki Y, Mitsuda A, Ohyama K, Horie Y, Suou T, Kawasaki H, Ikawa S (2000) Predictive factors for intrahepatic recurrence after percutaneous ethanol injection therapy for small hepatocellular carcinoma. Cancer 88:529–537

    Article  PubMed  CAS  Google Scholar 

  • Koda M, Murawaki Y, Mitsuda A, Oyama K, Okamoto K, Idobe Y, Suou T, Kawasaki H (2001) Combination therapy with transcatheter arterial chemoembolization and percutaneous ethanol injection compared with percutaneous ethanol injection alone for patients with small hepatocellular carcinoma: a randomized control study. Cancer 92:1516–1524

    Article  PubMed  CAS  Google Scholar 

  • Kojiro M (2004) Focus on dysplastic nodules and early hepatocellular carcinoma: an eastern point of view. Liver Transpl 10:S3–S8

    Article  PubMed  Google Scholar 

  • Kurokohchi K, Watanabe S, Masaki T, Hosomi N, Miyauchi Y, Himoto T, Kimura Y, Nakai S, Deguchi A, Yoneyama H, Yoshida S, Kuriyama S (2005) Comparison between combination therapy of percutaneous ethanol injection and radiofrequency ablation and radiofrequency ablation alone for patients with hepatocellular carcinoma. World J Gastroenterol 11:1426–1432

    PubMed  Google Scholar 

  • Lencioni R, Crocetti L (2005) A critical appraisal of the literature on local ablative therapies for hepatocellular carcinoma. Clin Liver Dis 9:301–314

    Article  PubMed  Google Scholar 

  • Lencioni R, Llovet JM (2005) Percutaneous ethanol injection for hepatocellular carcinoma: alive or dead? J Hepatol 43:377–380

    Article  PubMed  Google Scholar 

  • Lencioni R, Pinto F, Armillotta N, Bassi AM, Moretti M, Di Giulio M, Marchi S, Uliana M, Della Capanna S, Lencioni M, Bartolozzi C (1997) Long-term results of percutaneous ethanol injection therapy for hepatocellular carcinoma in cirrhosis: a European experience. Eur Radiol 7:514–519

    Article  PubMed  CAS  Google Scholar 

  • Lencioni RA, Allgaier HP, Cioni D, Olschewski M, Deibert P, Crocetti L, Frings H, Laubenberger J, Zuber I, Blum HE (2003) Small hepatocellular carcinoma in cirrhosis: randomized comparison of radio-frequency thermal ablation versus percutaneous ethanol injection. Radiology 228:235–240

    Article  PubMed  Google Scholar 

  • Lin SM, Lin CJ, Lin CC, Hsu CW, Chen YC (2004) Radiofrequency ablation improves prognosis compared with ethanol injection for hepatocellular carcinoma ≤ 4 cm. Gastroenterology 127:1714–1723

    Article  PubMed  Google Scholar 

  • Lin SM, Lin CJ, Lin CC, Hsu CW, Chen YC (2005) Randomized controlled trial comparing percutaneous radiofrequency thermal ablation, percutaneous ethanol injection, and percutaneous acetic acid injection to treat hepatocellular carcinoma of 3cm or less. Gut 54:1151–1156

    Article  PubMed  CAS  Google Scholar 

  • Livraghi T, Giorgio A, Marin G, Salmi A, de Sio I, Bolondi L, Pompili M, Brunello F, Lazzaroni S, Torzilli G, Zucchi AL (1995) Hepatocellular carcinoma and cirrhosis in 746 patients: long-term results of percutaneous ethanol injection. Radiology 197:101–108

    PubMed  CAS  Google Scholar 

  • Livraghi T, Goldberg SN, Lazzaroni S, Meloni F, Solbiati L, Gazelle GS (1999) Small hepatocellular carcinoma: treatment with radio-frequency ablation versus ethanol injection. Radiology 210:655–661

    PubMed  CAS  Google Scholar 

  • Livraghi T, Meloni F, Morabito A, Vettori C (2004) Multimodal image-guided tailored therapy of early and intermediate hepatocellular carcinoma: long-term survival in the experience of a single radiologic referral center. Liver Transpl 10:S98–S106

    Article  PubMed  Google Scholar 

  • Llovet JM (2005) Updated treatment approach to hepatocellular carcinoma. J Gastroenterol 40:225–235

    Article  PubMed  Google Scholar 

  • Llovet JM, Burroughs A, Bruix J (2003) Hepatocellular carcinoma. Lancet 362:1907–1917

    Article  PubMed  Google Scholar 

  • Lubienski A, Bitsch RG, Schemmer P, Grenacher L, Düx M, Kauffmann GW (2004) Long-term results of interventional treatment of large unresectable hepatocellular carcinoma (HCC): significant survival benefit from combined transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) compared to TACE monotherapy. Fortschr Röntgenstr 176:1794–1802

    Article  CAS  Google Scholar 

  • Mor E, Kaspa RT, Sheiner P, Schwartz M (1998) Treatment of hepatocellular carcinoma associated with cirrhosis in the era of liver transplantation. Ann Intern Med 129:643–653

    PubMed  CAS  Google Scholar 

  • Omata M, Tateishi R, Yoshida H, Shiina S (2004) Treatment of hepatocellular carcinoma by percutaneous tumor ablation methods: ethanol injection therapy and radiofrequency ablation. Gastroenterology 127:S159–S166

    Article  PubMed  Google Scholar 

  • Sakamoto M, Hirohashi S (1998) Natural history and prognosis of adenomatous hyperplasia and early hepatocellular carcinoma: multi-institutional analysis of 53 nodules followed up for more than 6 months and 141 patients with single early hepatocellular carcinoma treated by surgical resection or percutaneous ethanol injection. Jpn J Clin Oncol 28:604–608

    Article  PubMed  CAS  Google Scholar 

  • Sala M, Llovet JM, Vilana R, Bianchi L, Sole M, Ayuso C, Brú C, Bruix J, Barcelona Clinic Liver Cancer Group (2004) Initial response to percutaneous ablation predicts survival in patients with hepatocellular carcinoma. Hepatology 40:1352–1360

    Article  PubMed  Google Scholar 

  • Shiina S, Tagawa K, Unuma T, Takanashi R, Yoshiura K, Komatsu Y, Hata Y, Niwa Y, Shiratori Y, Terano A, Sugimoto T (1991) Percutaneous ethanol injection therapy for hepatocellular carcinoma: a histopathologic study. Cancer 68:1524–1530

    Article  PubMed  CAS  Google Scholar 

  • Shiina S, Teratani T, Obi S, Sato S, Tateishi R, Fujishima T, Ishikawa T, Koike Y, Yoshida H, Kawabe T, Omata M (2005) A randomized controlled trial of radiofrequency ablation with ethanol injection for small hepatocellular carcinoma. Gastroenterology 129:122–130

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institut für Radiologie der Universität Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany

    Andreas Lubienski MD & Martin Simon MD

  2. Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Klinikum Bogenhausen, Engelschalkinger Strasse 77, 81925, Munich, Germany

    Thomas K. Helmberger MD (Professor)

Authors
  1. Andreas Lubienski MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Martin Simon MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Thomas K. Helmberger MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Institute for Diagnostic and Interventional Radiology University Hospital, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany

    Thomas J. Vogl MD (Professor) & Martin G. Mack MD (PD) (Professor) &  (PD)

  2. Department of Diagnostic and Interventional Radiology and Nuclear Medicine Klinikum Bogenhausen, Academic Teaching, Hospital of the Technical University Munich, Engelschalkingerstrasse 77, 81925, Munich, Germany

    Thomas K. Helmberger MD (Professor) (Professor)

  3. Department of Clinical Radiology University Hospitals — Grosshadern and Innenstadt, Ludwig-Maximilians-University of Munich, Marchioninistrasse 15, 81377, Munich, Germany

    Maximilian F. Reiser MD (Professor and Chairman) (Professor and Chairman)

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Lubienski, A., Simon, M., Helmberger, T.K. (2008). Percutaneous Alcohol Instillation. In: Vogl, T.J., Helmberger, T.K., Mack, M.G., Reiser, M.F. (eds) Percutaneous Tumor Ablation in Medical Radiology. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-68250-9_13

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-68250-9_13

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-22518-8

  • Online ISBN: 978-3-540-68250-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation