Endoscopic ultrasound (EUS)-guided ethanol injection for hepatocellular carcinoma difficult to treat with percutaneous local treatment

Nakaji, So; Hirata, Nobuto; Iwaki, Kosuke; Shiratori, Toshiyasu; Kobayashi, Masayoshi; Inase, Masami

doi:10.1055/s-0032-1309918

Cited by 25 publications

(21 citation statements)

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“…In addition, a systematic review by searching from PubMed up to August 2016 was performed. The summary of 11 studies of ethanol ablation and 125 I brachytherapy of the hepatocellular carcinoma was presented in Table 2 121314151617 and Table 3 918192021.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of endoscopic ultrasonography-guided interventional treatment for refractory malignant left-sided liver tumors: a case series of 26 patients

Jiang

Deng

Tian³

et al. 2016

Sci Rep

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This study aimed to compare the efficacy and safety of EUS-guided ethanol injection and 125I seed brachytherapy for malignant left-sided liver tumors which were difficult for trans-abdominal intervention. The study protocol was registered at Clinicaltrials.gov (NCT02816944). Twenty-six patients were consecutively and prospectively hospitalized for EUS-guided interventional treatment of refractory malignant left-sided liver tumors between June 2014 and June 2016. Liver masses were detected using EUS in 25 of 26 (96.2%) patients. EUS-guided interventional treatment was completed uneventfully in 23 of 26 (88.5%) patients using anhydrous ethanol injection (n = 10) or iodine-125 seed implantation (n = 13). Six months later, complete response was achieved in 15 of 23 (65.2%) patients and partial response in 8 of 23 (34.8%) patients. Patients with tumor residual have second-look EUS-guided interventional treatment (n = 5), radiotherapy (n = 2) or surgical resection (n = 1). Complete response was achieved after repeated interventional treatment in 3 of 5 patients who underwent second EUS-guided intervention; 2 patients required additional surgical resection but one succeed. No significant complications occurred. Therefore EUS-guided 125I seed brachytherapy is an effective and safe treatment modality for radical operation or promising palliative control of malignant left-sided liver tumors refractory to trans-abdominal intervention.

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Section: Resultsmentioning

confidence: 99%

Efficacy and safety of endoscopic ultrasonography-guided interventional treatment for refractory malignant left-sided liver tumors: a case series of 26 patients

Jiang

Deng

Tian³

et al. 2016

Sci Rep

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“…In addition, several cases in which EUS was used to guide ablative liver tumor therapy or abscess drainage have been reported. [8910]…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the viability of hepatocellular carcinoma in the caudate lobe using contrast-enhanced endoscopic ultrasonography after transarterial chemoembolization

Nakaji

Hirata

2016

Endosc Ultrasound

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A 71-year-old female was diagnosed with hepatocellular carcinoma (HCC). The tumor measured 65 mm in diameter and was located in the caudate lobe. Transarterial chemoembolization (TACE) was performed repeatedly; however, a follow-up dynamic computed tomography (CT) scan showed that the tumor remained viable. Thus, TACE was performed using drug-eluting beads that had been preloaded with epirubicin. Contrast-enhanced endoscopic ultrasonography (CE-EUS) was conducted for evaluating the treatment effects. First, we detected the internal part of the tumor. Then, a perflubutane suspension was injected intravenously. Next, CE-EUS was performed for the external ventral part of the tumor in the same manner. The perflubutane flowed into the tumor and spread into both its internal and external ventral regions. Thus, we considered that the tumor was still viable and planned to carry out TACE again. CE-EUS could be a useful tool for evaluating the treatment effects of TACE on HCC deep inside the liver.

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“…Several case reports have shown the possible role of EUS in the treatment of patients with HCC lesions that are difficult to be accessed by the traditional percutaneous methods. [103][104][105] In the first case report, neodymium-doped yttrium aluminum garnet (Nd:YAG) laser ablation of a lesion in the caudate liver lobe was successfully accomplished, 103 while in the other two case reports ethanol ablation of difficult-to-treat HCCs was performed. 104,105 More recently, Nakaji et al 106 reported their long-term experience with EUS-guided ethanol ablation in 12 patients with early-stage HCC.…”

Section: Eus For Evaluation and Treatment Of Solid Liver Lesionsmentioning

confidence: 99%

Endoscopic Ultrasound for the Hepatologist: A Comprehensive Review

et al. 2018

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In the last few years, the diagnostic and therapeutic utilization of endoscopic ultrasound (EUS) for a variety of liver conditions has exponentially grown. We performed a thorough search for all available studies on the performance of diagnostic and therapeutic EUS in the field of hepatology. This article reviews the indication of EUS in the evaluation and treatment of portal hypertension, portal vein pressure measurement, focal liver lesions, and parenchymal liver diseases, and presents all the clinical evidences available so far in this regard. All the review data suggest that EUS is becoming an increasingly important tool in the armamentarium of the hepatologists for the management of certain liver-related conditions. Implementation in the education of the hepatologists of means to become more familiar with both diagnostic and therapeutic capabilities of EUS is warranted.

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Endoscopic ultrasound (EUS)-guided ethanol injection for hepatocellular carcinoma difficult to treat with percutaneous local treatment

Cited by 25 publications

References 0 publications

Efficacy and safety of endoscopic ultrasonography-guided interventional treatment for refractory malignant left-sided liver tumors: a case series of 26 patients

Efficacy and safety of endoscopic ultrasonography-guided interventional treatment for refractory malignant left-sided liver tumors: a case series of 26 patients

Evaluation of the viability of hepatocellular carcinoma in the caudate lobe using contrast-enhanced endoscopic ultrasonography after transarterial chemoembolization

Endoscopic Ultrasound for the Hepatologist: A Comprehensive Review

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