M. Lu, M. Kuang, X. Xie, G. Liu, Z. Xu, H. Xu; Guangzhou/CN

Purpose
To investigate the local effectiveness and complications of ethanol ablation (EA) using a multi-pronged injection needle in the treatment of hepatocellular carcinoma (HCC).

Material and methods
One hundred and one patients (85 male and 16 female; age range, 28-76 years) with 121 HCC nodules ranged 1.4-7.0 cm (mean, 3.2 cm ± 1.2) were treated by percutaneous ultrasound-guided EA using a multi-pronged injection needle. There were 60 small tumors (1.4-3.0 cm), 51 intermediate (3.1-5.0 cm) and nine large (5.1-7.0 cm).

Results
All EA procedures were completed in one treatment session. The volume of ethanol used to treat small, intermediate and large tumors were 22.4 mL ± 7.5, 38.7 mL ± 10.7, and 61.9 mL ± 19.0, respectively. Complete ablation (CA) rates in small, intermediate and large liver tumors were 93.4%, 86.3%, and 100.0%, respectively. In a follow-up of 1-19 months (mean, 7.8 ), local tumor progression (LTP) was observed in eight treated tumors (6.6%). Three major complications (acute renal failure, liver coma and subcutaneous hemorrage) and five minor complications (persistant pain, transient hematuria, drunken) were observed. Total complication rate was 7.9%. There was not treatment-related death.

Conclusion
Multi-pronged EA appears to be an effective, safe and simple modality for the treatment of HCC. Compared with traditional EA, this technique could eradicate a HCC nodule sized up to 5 cm within one treatment session.