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

Table 1 Baseline data of the patients

Variables	Values
Mean age (yr)	57.2
Cases of HBV-related liver disease	61.0
Cases of HCV-related liver disease	0.0
Mean AST (U/L)	43.4
Mean ALT (U/L)	49.5
Mean total bilirubin (μmol/L)	26.2
Mean AFP (ng/mL)	963.9
Mean tumor size (cm)	8.3

HBV: Hepatitis B virus; HCV: Hepatitis C virus; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; AFP: α-fetoprotein.

Table 2 Variables and classes by univariate and multivariate analyses

Variables	Classes
	A	B	C	D
Sex	M (52)	F (11)
Age (yr)	< 55 (36)	> 55 (27)
No. of lesions	Solitary (43)	Multiple (20)
Tumor size (cm)	5-10 (41)	> 10 (22)
Tumor extension	1 lobe (46)	2 lobe (17)
Tumor margin	Clear (28)	Not clear (35)
AFP	< 400 (22)	> 400 (41)
Portal thrombosis	Absent (51)	Present (12)
Ascites	Absent (56)	Present (7)
Child grade	A (38)	B (25)
Okuda stage	I (29)	II (34)
TACE (number of times)	1 (11)	2 (26)	3 (20)	4 (6)
PEA (number of times)	1 (3)	2 (6)	3 (31)	> 4 (23)
Total ethanol dose	10-30 (2)	- 60 (9)	- 90 (29)	> 90 (23)

In the parenthesis are numbers of patients. AFP: α-fetoprotein; TACE: Transcatheter arterial chemoembolization; PEA: Percutaneous ethanol ablation.

Table 3 Factors affecting survival by univariate analysis n (%)

Variables	Class	Survival			P value
		1 yr	3 yr	5 yr
Sex	A	27 (51.9)	16 (30.8)	9 (17.3)
	B	7 (63.6)	4 (36.4)	2 (18.2)	0.9241
Age (yr)	A	21 (58.3)	11 (30.6)	5 (13.9)
	B	13 (48.1)	9 (33.3)	6 (22.2)	0.2231
No. of lesions	A	25 (58.1)	17 (39.5)	10 (23.3)
	B	9 (45.0)	3 (15.0)	1 (5.0)	0.01451
Tumor size	A	28 (68.3)	18 (43.9)	11 (26.8)
	B	6 (27.3)	2 (9.1)	0 (0)	0.00411
Tumor extension	A	29 (63.0)	18 (39.1)	11 (23.9)
	B	5 (29.4)	2 (11.8)	0 (0)	0.00541
Tumor margin	A	25 (89.3)	15 (53.6)	11 (39.3)
	B	9 (25.7)	5 (14.3)	0 (0)	0.00521
AFP	A	16 (72.7)	10 (45.5)	9 (40.9)
	B	18 (43.9)	10 (24.4)	2 (4.9)	0.00301
Portal thrombosis	A	31 (60.8)	18 (35.3)	11 (21.6)
	B	3 (25.0)	2 (16.7)	0 (0)	0.01111
Ascites	A	32 (57.1)	19 (33.9)	11 (19.6)
	B	2 (28.6)	1 (14.3)	0 (0)	0.01151
Child grade	A	28 (73.7)	17 (44.7)	11 (28.9)
	B	6 (24.0)	3 (12.0)	0 (0)	0.01321
Okuda stage	A	22 (75.9)	14 (48.3)	10 (34.5)
	B	12 (35.3)	6 (17.6)	1 (2.9)	0.01501
TACE (No. of times)	A	3 (27.2)	2 (18.2)	1 (9.1)
	B	13 (50.0)	7 (26.9)	3 (11.5)
	C	13 (65.0)	8 (40.0)	5 (25.0)
	D	5 (83.3)	3 (50.0)	2 (33.3)	0.17192
PEA (No. of times)	A	1 (33.3)	0 (0)	0 (0)
	B	2 (33.3)	1 (16.7)	0 (0)
	C	16 (48.5)	10 (32.3)	5 (16.1)
	D	15 (65.2)	9 (39.1)	6 (26.1)	< 0.00012
Total ethanol dose	A	0 (0)	0 (0)	0 (0)
	B	2 (33.3)	1 (16.7)	0 (0)
	C	15 (51.7)	9 (31.0)	5 (16.1)
	D	17 (73.9)	10 (43.5)	6 (26.1)	< 0.00012

¹P value: B vs A;

²P value: D vs A. AFP: α-fetoprotein; TACE: Transcatheter arterial chemoembolization; PEA: Percutaneous ethanol ablation.

Table 4 Significant factors predicting survival found using Cox proportional hazards model

Variables	Hazard ratio	P value
No. of lesions
Multiple vs single solitary lesions	2.626	0.001
Tumor margin
Not clear vs clear	2.439	0.000
Total ethanol dose
30-60 mL vs 10-30 mL	0.386	0.000
60-90 mL vs 10-30 mL	0.202	0.000
> 90 mL vs 10-30 mL	0.116	0.000