TY - JOUR
T1 - Survival of patients with advanced hepatocellular carcinoma
T2 - Sorafenib versus other treatments
AU - Kim, Hwi Young
AU - Park, Joong Won
AU - Nam, Byung Ho
AU - Kim, Hyun Keun
AU - Choi, Joon Il
AU - Kim, Tae Hyun
AU - Kim, Hyun Beom
AU - Kim, Chang Min
PY - 2011/11
Y1 - 2011/11
N2 - Although sorafenib is recommended for patients with advanced hepatocellular carcinoma (HCC), a substantial portion of HCC patients in Asia are still treated with other treatments, mainly due to the prohibitive cost of sorafenib. We aimed to evaluate the clinical outcome of patients treated with sorafenib and those treated with other modalities in a single-center cohort. Methods: We reviewed the medical records of two groups of consecutive patients with advanced HCC, according to applied treatment modalities, between January 2007 and September 2009 as follows: patients who received sorafenib for 6weeks or more (n=123) and patients who were treated with one or more of other treatments, including transarterial chemoembolization, radiation, and cytotoxic chemotherapy (n=253). Results: Overall survival did not differ significantly between these two groups (8.4 vs 8.2months; P=0.601). Significant prognostic factors were high α-fetoprotein (≥200ng/mL), massive/infiltrative intrahepatic tumors, macrovascular invasion, extrahepatic spread, and higher tumor-node-metastasis stage. Subgroup analysis, according to these factors, showed that sorafenib resulted in superior survival in patients with extrahepatic spread (hazard ratio [HR]=0.539; P=0.003) and massive/infiltrative tumors (HR=0.680; P=0.036). In the absence of each prognostic factor, other treatments were better than sorafenib. Conclusions: Considering the survival benefit for sorafenib over other treatments in patients with extrahepatic spread and massive/infiltrative intrahepatic tumors, these characteristics might be regarded as compelling indications for sorafenib.
AB - Although sorafenib is recommended for patients with advanced hepatocellular carcinoma (HCC), a substantial portion of HCC patients in Asia are still treated with other treatments, mainly due to the prohibitive cost of sorafenib. We aimed to evaluate the clinical outcome of patients treated with sorafenib and those treated with other modalities in a single-center cohort. Methods: We reviewed the medical records of two groups of consecutive patients with advanced HCC, according to applied treatment modalities, between January 2007 and September 2009 as follows: patients who received sorafenib for 6weeks or more (n=123) and patients who were treated with one or more of other treatments, including transarterial chemoembolization, radiation, and cytotoxic chemotherapy (n=253). Results: Overall survival did not differ significantly between these two groups (8.4 vs 8.2months; P=0.601). Significant prognostic factors were high α-fetoprotein (≥200ng/mL), massive/infiltrative intrahepatic tumors, macrovascular invasion, extrahepatic spread, and higher tumor-node-metastasis stage. Subgroup analysis, according to these factors, showed that sorafenib resulted in superior survival in patients with extrahepatic spread (hazard ratio [HR]=0.539; P=0.003) and massive/infiltrative tumors (HR=0.680; P=0.036). In the absence of each prognostic factor, other treatments were better than sorafenib. Conclusions: Considering the survival benefit for sorafenib over other treatments in patients with extrahepatic spread and massive/infiltrative intrahepatic tumors, these characteristics might be regarded as compelling indications for sorafenib.
KW - Hepatocellular carcinoma
KW - Sorafenib
KW - Survival
KW - Therapeutics
UR - http://www.scopus.com/inward/record.url?scp=80054908052&partnerID=8YFLogxK
U2 - 10.1111/j.1440-1746.2011.06751.x
DO - 10.1111/j.1440-1746.2011.06751.x
M3 - Article
C2 - 21517968
AN - SCOPUS:80054908052
SN - 0815-9319
VL - 26
SP - 1612
EP - 1618
JO - Journal of Gastroenterology and Hepatology (Australia)
JF - Journal of Gastroenterology and Hepatology (Australia)
IS - 11
ER -