Evaluation of transarterial chemoembolization combined with percutaneous ethanol ablation for large hepatocellular carcinoma

AIM:To assess the effects of combined transcatheter arterial chemoembolization(TACE) and percutaneous ethanol ablation(PEA) in patients with large hepatocellular carcinoma(HCC).METHODS:A total of 63 patients with unresectable large HCC were treated with TACE followed by PEA.The largest dimension of the tumors ranged from 5.3 cm to 17.8 cm.The survival rates,acute effects,toxicity and prognostic factors were analyzed.RESULTS:The cumulative survival rates at 1,3 and 5 years were 59.4%,28.4% and 15.8%,respectively(a median survival of 27.7 mo).Tumor area was reduced by more than 50% in 30(47.6%) cases.In 56 cases with increased α-fetoprotein(AFP) values,AFP levelwas declined by more than 75%.The combined therapy was generally well tolerated.Only two patients died from variceal bleeding associated with the therapy.The Cox proportional hazards model showed that the number of tumors,the tumor margin and the ethanol dose were independent prognostic factors.CONCLUSION:The combined TACE and PEA therapy is a promising approach for unresectable large HCC.