Percutaneous ethanol injection for patients with small hepatocellular carcinoma

  • Masaaki Ebara
  • Kazuhiko Kita
  • Masaharu Yoshikawa
  • Nobuyuki Sugiura
  • Masao Ohto


Hepatocellular carcinoma (HCC) arises in patients with chronic liver diseases, particularly in those with liver cirrhosis, at a rate of more than 80% in Japan [1, 2]. Because of periodic examinations with ultrasonography (US) [3, 4] and serum alpha-fetoprotein (AFP) measurement [5, 6] in high-risk patients with liver cirrhosis or chronic hepatitis, a large number of small HCC, often smaller than 2cm, have been diagnosed during follow-up of such patients.


Liver Cirrhosis Primary Liver Cancer Percutaneous Ethanol Injection Small Hepatocellular Carcinoma Poor Liver Function 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Okuda K, Fujimoto I, Hanai A, Urano Y (1987) Changing incidence of hepatocellular carcinoma in Japan. Cancer Res 47: 4967–4972PubMedGoogle Scholar
  2. 2.
    The Liver Cancer Study Group of Japan (1987) Primary liver cancer in Japan. Cancer 60: 1400–1411CrossRefGoogle Scholar
  3. 3.
    Shinagawa T, Ohto M, Kimura K, Tsunetomi S, Morita M, Saisho H, Tsuchiya Y, Saotome N, Karasawa E, Miki M, Ueno T, Okuda K (1984) Diagnosis and clinical features of small hepatocellular carcinoma with emphasis on the utility of real-time ultrasonography: A study in 51 patients. Gastroenterology 86: 495–502PubMedGoogle Scholar
  4. 4.
    Sheu JC, Sung JL, Chen DS, Yu JY, Wang TH, Su CT, Tsang YM (1984) Ultrasonography of small hepatic tumors using high-resolution linear-array real-time instruments. Radiology 150: 797–802PubMedGoogle Scholar
  5. 5.
    Okuda K, Kotoda K, Obata H, Hayashi N, Hisamitsu T, Tamiya M, Kubo Y, Yakushiji F, Nagata E, Jinnouchi S, Shimokawa Y (1975) Clinical observation during a relatively early stage of hepatocellular carcinoma with special reference to serum alpha-fetoprotein levels. Gastroenterology 69: 116–134Google Scholar
  6. 6.
    Kew M (1974) Alpha-fetoprotein in primary liver cancer and other diseases. Gut 15: 814–821PubMedCrossRefGoogle Scholar
  7. 7.
    Kanematsu T, Takenaka K, Matsumata T, Furuta T, Sugimachi K, Inokuchi K (1984) Limited hepatic resection effective for selected cirrhotic patients with primary liver cancer. Ann Surg 199: 51–56PubMedCrossRefGoogle Scholar
  8. 8.
    Takayasu K, Muramatsu Y, Moriyama N, Yamada T, Hasegawa H, Okazaki N, Hirohashi S, Tsugane S (1987) Clinico-radiological evaluation of recurrence in the residual liver following hepatectomy in 97 patients with hepatocellular carcinoma. Jpn J Gastroenterol 84: 1424–1432Google Scholar
  9. 9.
    Yamada R, Sato M, Kawabata M, Nakatsuka H, Nakamura K, Takashima S (1983) Hepatic artery embolization in 120 patients with unresectable hepatoma. Radiology 148: 397–401PubMedGoogle Scholar
  10. 10.
    Ohto M, Karasawa E, Tsuchiya Y, Kimura K, Saisho H, Ono T, Okuda K (1980) Ultrasonically guided percutaneous contrast medium injection and aspiration biopsy using a real-time puncture transducer. Radiology 136: 171–176PubMedGoogle Scholar
  11. 11.
    Sugiura N, Takara K, Ohto M, Okuda K, Hirooka N (1983) Treatment of small hepatocellular carcinoma by percutaneous injection of ethanol into tumor with real-time ultrasound monitoring. Acta Hepatol Jpn 24: 920Google Scholar
  12. 12.
    Ohto M, Ebara M, Watanabe Y, Sugiura N, Shinagawa T, Okuda K (1988) Percutaneous ethanol injection (PEI) therapy for small hepatocellular carcinoma: Evaluation of its utility on the basis of tumor-images and survival after therapy. Japanese J of Medical Imag 7: 25Google Scholar
  13. 13.
    Ebara M, Ohto M, Sugiura N, Kita K, Yoshikawa M, Okuda K, Kondo F, Kondo Y (1990) Percutaneous ethanol injection for the treatment of small hepatocellular carcinoma: Study of 5 patients. Journal of Gastroenterol and Hepatol 5: 616–626CrossRefGoogle Scholar
  14. 14.
    Livraghi T, Festi D, Monti F, Salmi A, Vettori C (1986) US-guided percutaneous alcohol injection of small hepatic and abdominal tumors. Radiology 161: 309–312PubMedGoogle Scholar
  15. 15.
    Sheu JC, Huang GT, Chen DS, Sung JL, Yan PM, Wei TC, Lai MY, Su CT, Tsang YM (1987) Small hepatocellular carcinoma: Intratumor ethanol treatment using new needle and guidance systems. Radiology 163: 43–48PubMedGoogle Scholar
  16. 16.
    Shiina S, Yasuda H, Muto H, Tagawa K, Unuma T, Ibukuro K, Inoue Y, Takahashi R (1987) Percutaneous ethanol injection in the treatment of liver neoplasms. AJR 149: 949–952PubMedGoogle Scholar
  17. 17.
    Ebara M, Ohto M, Shinagawa T, Sugiura N, Kimura K, Matsutani S, Morita M, Saisho H, Tsuchiya Y, Okuda K (1986) Natural history of minute hepatocellular carcinoma smaller than three centimeters complicating cirrhosis: A study in 22 patients. Gastroenterology 90: 289–298PubMedGoogle Scholar
  18. 18.
    Ebara M, Ohto M, Kondo F (1989) Strategy for early diagnosis of hepatocellular carcinoma ( HCC ). Ann Acad Med 18: 83–89Google Scholar
  19. 19.
    Young SW, Turner RJ, Castellino RA (1980) A strategy for the contrast enhancement of malignant tumors using dynamic computed tomography and intravascular pharmacokinetics. Radiology 137: 137–147PubMedGoogle Scholar
  20. 20.
    Ebara M, Ohto M, Watanabe Y, Kimura K, Saisho H, Tsuchiya Y, Okuda K, Arimizu N, Kondo F, Ikehira H, Fukuda N, Tateno Y (1986) Diagnosis of small hepatocellularcarcinoma: Correlation of MR imaging and tumor histologic studies. Radiology 159: 371–377PubMedGoogle Scholar
  21. 21.
    Child CG, Turcotte JG (1964) Surgery and portal hypertension. In: Child CG (ed) The liver and portal hypertension. WB Saunders, Philadelphia 50Google Scholar
  22. 22.
    Kondo Y, Kondo F, Wada K, Okabayashi A (1986) Pathologic features of small hepatocellular carcinoma. Acta Pathol Jpn 36: 1149–1161PubMedGoogle Scholar

Copyright information

© Springer-Verlag Tokyo 1992

Authors and Affiliations

  • Masaaki Ebara
    • 1
  • Kazuhiko Kita
    • 1
  • Masaharu Yoshikawa
    • 1
  • Nobuyuki Sugiura
    • 1
  • Masao Ohto
    • 1
  1. 1.First Department of Medicine, School of MedicineChiba UniversityChibaJapan

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