A combination therapy of ethanol injection and radiofrequency ablation under general anesthesia for the treatment of hepatocellular carcinoma

Table 1 Characteristics of patients enrolled in the present study

	Group G	Group L
Number of patients	22	40
Male/Female	15/7	27/13
Age (yr)
Mean	64	65
Range	48-75	49-72
Tumor size (cm)
Mean	2.8	2.9
Range	1.0-3.5	1.5- 3.3
Injected ethanol (mL)
Mean	5.2	2.1
Range	2.0-15	1.5-2.5
Child-Pugh grade
A	14	25
B	7	14
C	1	1

Table 2 Comparison of the volume of coagulated necrosis and energy requirement between the groups treated with expandable and straight electrode

	T-S (cm)	ETOH (mL)	L (cm)	S (cm)	H (cm)	V (cm3)	M (cm3)	T-ENE (J)	T-ENE/V (J/cm3)	T-ENE/M (J/cm3)
Group L (n = 40)	2.0 ± 0.8	3.0 ± 1.9	3.5 ± 0.6	2.8 ± 0.4	3.0 ± 0.5	15.9 ± 5.2	10.1 ± 8.2	21 565 ± 9631	1636 ± 791	2406 ± 1819
Group G (n = 15)	2.1 ± 0.8	6.1 ± 3.4	3.6 ± 1.1	3.2 ± 0.6	3.2 ± 0.8	22.5 ± 14.9	15.9 ± 12.1	37 207 ± 20 583	2409 ± 2045	3594 ± 2727
P value	0.56	0.0007	0.64	0.10	0.31	0.045	0.06	0.0095	0.10	0.11

Twenty-four HCC were treated with time-lag PEI-RFA with straight type electrode, while 15 HCC were treated with time-lag PEI-RFA with expandable type electrode. After treatment, the longest and the shortest diameters, and the height of the coagulated necrosis were estimated by helical dynamic CT and the approximation volume of total and marginal coagulated necrosis were calculated. Each datum expresses mean ± SD. Each abbreviation in the table is expressing as follows: T-S: Tumor size; EtOH: Amount of ethanol; L: Longest diameter; S: Shortest diameter; H: Height; V: Volume of coagulated necrosis; M: Volume of marginal coagulation; D: Duration of ablation; T-ENE: Total energy requirement; T-ENE/V: Energy requirement per unit volume for whole coagulation; T-ENE/M: Energy requirement per unit volume for inducing marginal coagulation.

Table 3 Results of L-EI-RFA, T-EI-RFA and O-EI-RFA

Location		T-S (cm)	Ins	EtOH (mL)	A-A (L x S x H) (cm)	V (cm3)	M (cm3)
L-EI-RFA
No. 1	S3	1.5	Cool-tip	15	3.2 × 2.7 × 2.6	11.8	10.0
No. 2	S2	3.0	Cool-tip	8	4.2 × 4.2 × 4.2	38.7	24.0
No. 3	S4	1.5	Cool-tip	2	2.2 × 2.2 × 2.2	5.60	3.81
No. 4	S2	3.0	Cool-tip	7	6.7 × 5.0 × 3.7	64.8	50.7
No. 5	S3	2.5	Cool-tip	8	3.7 × 3.7 × 3.4	24.4	16.2
No. 6	S4	1.0	Cool-tip	7	2.2 × 2.2 × 2.3	5.83	5.30
No. 7	S2	1.5	RITA	2	4.0 × 4.0 × 4.0	33.0	31.0
No. 8	S2	1.5	RITA	2	3.5 × 2.5 × 3.0	19.0	17.0
T-EI-RFA
No. 9	S6	2.5	Cool-tip	7	3.7 × .2 × 3.2	19.8	11.7
No. 10	S8	1.0	RTC	3	4.1 × 2.5 × 3.2	17.2	16.6
No. 11	S8	2.0	Cool-tip	12	4.2 × 4.2 × 3.7	34.1	30.0
No. 12	S8	2.5	Cool-tip	5	3.2 × 3.2 × 3.2	17.1	8.97
No. 13	S8	2.0	Cool-tip	4	3.0 × 3.0 × 2.5	11.8	7.59
No. 14	S8	2.0	Cool-tip	5	3.5 × 3.5 × 3.5	22.4	18.3
No. 15	S8	2.0	Cool-tip	5	4.5 × 3.0 × 3.5	24.7	20.5
No. 16	S8	3.5	Cool-tip	3	2.0 × 2.0 × 2.0	4.20	3.70
No. 17	S8	2.0	Cool-tip	4	2.5 × 2.5 × 4.0	13.1	8.90
O-EI-RFA
No. 18	S3	1.5	RITA	2	3.3 × 2.5 × 3.0	13.0	8.90
No. 19	S8	2.5	Cool-tip	7	4.2 × 3.2 × 3.7	26.0	17.9
No. 20	S7	1.0	RTC	2	3.0 × 2.5 × 2.5	9.81	9.29
No. 21	S3	1.5	RTC	2	2.0 × 2.0 × 1.5	3.14	1.37
No. 22	S3	1.5	RTC	2	4.0 × 4.0 × 4.0	25.1	23.4

Eight HCC were treated with L-EI-RFA, Nine HCC were treated with T-EI-RFA and five HCC were treated with O-EI-RFA. Location of the tumor, tumor size (T-S), instruments for ablation (Ins), amounts of injected ethanol (EtOH), ablated area (A-A), [longest diameter (L) × shortest diameter (S) × height (H)], volume of coagulated necrosis (V) and volume of marginal coagulated necrosis (M) are shown.