Objective: This study was To investigate the therapeutic efficacy on patients with 5-8 cm noninfiltrating hepatocellular carcinoma (HCC) treated with percutaneous ethanol injection (PEI), percutaneous acetic acid injection(PAI), percutaneous hot saline injection (PHSI), interstitial photodynamic therapy (IPDT),radiofrequency ablation (RFA), and combined interventional therapies (transcatheter arterial embolization plus PEI or RFA).
Methods: Sonographically guided percutaneous interventional therapies were performed in 204 patients with 5-8 cm HCC from 1992-2007. PEI was performed in 55 cases, PAI in 20, PHSI in 20, IPDT in 24, RFA in 30, and combined interventional therapies (CIT) in 44. Their survival rates were compared with that of 56 patients underwent surgical resection.
Results: The survival rates in PHSI group was significantly lower than the other group (p<0.01) .The recurrences at the local tumor-treated sites in the 5-year follow-up varied from 8.9% to 75.0%: PHSI group was significantly higher than those of the other groups (p<0.05), and that of the surgical resection group was significantly lower than those of PEI, PHSI, IPDT, RFA, and CIT group (p<0.05), but was not significantly different from that of PAI group. In the 5-year follow-up, the local intrahepatic or remote metastases varied from 62.5% to 80.0%; there were no significant differences between all groups (p>0.05).
Conclusions: The survival rates were not significant differences except the PHSI group. We consider that RFA, PEI or CIT appears to an effective, safe, and relatively simple procedure for the treatment of noninfiltrating HCC lesions 5-8cm in diameter in patients with cirrhosis and well-preserved hepatic function.