Portal long-term survival

There have been three studies of the effects of percutaneous ethanol injections in the treatment of hepatocellular carcinoma, either alone (12,13) or in combination with transcatheter arterial embolization (14). The procedure was effective and safe and improved long-term survival. Adverse effects were generally mild and of short duration, and commonly included abdominal pain, fever, intoxication (especially among non-drinkers), transient rises in serum transaminases, and chemical thrombosis of the tributary branch of the portal vein. Hepatic infarction has been reported in two patients with hepatocellular carcinoma after percutaneous ethanol injection of the tumors (15). Both patients had previously been treated with transcatheter arterial infusion using a suspension of styrene maleic acid neocarzinostatin, and the liver damage may have occurred through a combination of arterial damage due to the neocarzinostatin and vasculitis caused by flow of the injected ethanol into a portal vein branch. 

Combination Therapy Chemoembolization and Transportal Ethanol Injection Yamakodo et al. (1999) reported the long-term efficacy of TACE combined with transportal ethanol injection (TPEl) in patients with HCC > 2 cm in diameter. Transhepatic portal access was performed 2-6 weeks subsequent to TACE and ethanol (10-65 ml) was injected into the portal vein branch supplying the involved segment. Technical success was achieved in all patients, but hepatic failure developed in two (8%) patients. The 1- to 6-year survival rates were 87%, 72%, 72%, 63%, 51%, and 51%, respectively. 

Elias D, Ouellet JF, de Baere T et al. (2002) Preoperative selective portal vein embolization before hepatectomy for liver metastases long-term results and impact on survival. Surgery 131 294-299... 

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