Long-term outcome of percutaneous ethanol injection therapy for minimum-sized hepatocellular carcinoma

Table 1 Characteristics of 31 patients with liver cirrhosis and small HCC

Parameter
Sex (male:female)	23:8
Age (yr) (mean ± SD)	63.8 ± 8.9
Cause of cirrhosis
HCV	29
Non-HCV	2
Liver dysfunction
Child-Pugh A	17
Child-Pugh B	14
AFP level (&mgr;g/L)
≤ 20	15
> 20	16
Tumor multiplicity
Uninodular	21
Multinodular	10
Tumor diameter (mm) (mean ± SD)	11.9 ± 2.4
≤ 10	12
11-15	19
Histological characteristics
Well-differentiated	18
Well to moderately differentiated	13
Arterial blood flow
Positive	9
Negative	13
Portal blood flow
Positive	12
Negative	9

Table 2 Cause of death of post-PEI patients with small HCC, according to Child-Pugh classification and number of treatment sessions

	Child-Pugh classification		Number of treatment sessions
	A (n = 10)	B (n = 13)	1st	2nd	3rd	4th	5th
Cancer growth	2	2	0	3	0	0	0
Hepatic failure
Cancer (+)	7	6	3	2	2	1	5
Cancer (–)	0	2
Other	1	3	3	0	0	0	0

Table 3 Analysis of the prognostic value of patient- and tumor-related factors

		Probability of survival (%)
Factor	n	3-yr	5-yr	7-yr	10-yr	P value
Sex						0.595
Male	23	73.7	59.5	29.7	11.1
Female	8	62.5	33.3	0	0.0
Age (yr)						0.475
≤ 65	18	77.4	59.5	29.8	9.9
> 65	13	61.5	35.9	23.9	0.0
Cause of cirrhosis
HCV	29	72.2	46.2	23.1	15.4
Non-HCV	2	-	-	-	-
Liver dysfunction						0.025
Child-Pugh A	17	76.0	76.0	42.2	15.8
Child-Pugh B	14	64.3	17.1	8.6	0.0
AFP level (&mgr;g/L)						0.139
≤ 20	15	79.4	56.9	42.6	21.3
> 20	16	62.5	37.5	18.7	0.0
Tumor multiplicity						0.751
Uninodular	21	75.9	50.6	36.1	13.5
Multinodular	10	60.0	37.5	12.5	12.5
Tumor diameter (mm)						0.336
≤ 10	12	74.1	64.8	32.4	21.6
11-15	19	68.4	40.9	24.6	12.2
Histological characteristics						0.119
Well-differentiated	18	83.3	58.0	33.2	22.1
Well to moderately differentiated	13	61.5	38.5	19.2	0.0
Arterial blood flow						0.269
Positive	9	64.8	38.9	38.9	38.9
Negative	13	61.5	30.8	10.2	0.0
Portal blood flow						0.458
Positive	12	58.3	33.3	16.7	0.0
Negative	9	64.8	38.9	38.9	0.0

Table 4 Factors affecting survival of patients with HCC treated by PEI, determined by stepwise regression analysis

Factors	Hazard ratio	95% CI	P value
Child-Pugh class
A	1
B	5.89	1.50-23.15	0.011

Table 5 Characteristics of patients according to Child-Pugh class

Parameter	Class A (n = 17)	Class B (n = 14)	P value
Sex (male:female)	16:1	7:7	0.017
Age (yr) (mean ± SD)	61.2 ± 8.3	66.9 ± 8.9	NS
Cause of cirrhosis
HCV	15	14	NS
Non- HCV	2	0
AFP level
≤ 20 &mgr;g/L	9	6	NS
> 20 &mgr;g/L	8	8
Tumor multiplicity
Uninodular	11	10	NS
Multinodular	6	4
Tumor diameter (mm) (mean ± SD)
≤ 10	7	5	NS
11-15	10	9
Histological characteristics
Well-differentiated	9	9	NS
Well to moderately differentiated	8	5
Arterial blood flow
Positive	5	4	NS
Negative	5	8
Portal blood flow
Positive	7	5	NS
Negative	4	5

NS: Not significant.

Table 6 Recurrence of HCC initially treated by PEI (n = 25)

Location of recurrence
Same segment	8 (32.0%)
Same and other segments	7 (28.0%)
Other segments	8 (32.0%)
Others1	2 (8.0%)
Tumor diameter at detection (mm)
≤ 10	8 (32.0%)
11-15	9 (36.0%)
16-20	4 (16.0%)
21-30	2 (8.0%)
≥ 31	0
Others	2 (8.0%)

¹In two cases, tumor thrombus was seen in portal vein and HCC metastasizing to distant site (sacrum and lumbar vertebra), respectively.