AN EVALUATION OF THE TREATMENT OF HEPATIC TUMORS USING ULTRASONOGRAPHY GUIDED INTRALESIONAL INJECTION OF ETHANOL

Abstract

Hepatocellular carcinoma (HCC) Is one of the commonest malignancies reported worldwide, ranked as the seventh most common malignant tumor in males and the ninth in females.The treatment of choice for a small percentage of patients with localized HCC is hepatic resection (HR.) however; -a large number of patients are not operable. For these patients PElT has emerged as a treatment option, especially in those with poor hepatic function. In this study, an attempt was made to evaluate the feasibility and efficacy of this new modality for the treatment of 40 patients with hepatic . neoplastic lesions with a mean age of 54.8 years.Recruited patients were

divided into 2 groups according to the diameter of the lesion: Group I (n=19), patients-with lesions 5 em or less, Group II (n=21), patients with lesions greater than 5 em. All patients were initially subjected to history taking, physical examination, laboratory studies, US and CT imaging and US guided FNAC of the lesions. Patients were only included when they were found to be unfit or refused surgery irrespective of tumor size, number, Child class, presence of ascites or portal vein thrombosis. All patients had evidence of cirrhosis. Informed consent was obtained from all patients. All patients had percutaneous US guided intralesional alcohol injection of their lesions. All sessions were performed on an outpatient basis and were tailored to inject the estimated volume over the shortest time period. The number of sessions varried between 1 and 13 and the volume injected per session varried between 3 and 25 mi. Patients were then enlisted in a follow-up protocol with measurement of their AFP level, US