Sorafenib for the treatment of advanced hepatocellular carcinoma with extrahepatic metastasis: a prospective multicenter cohort study

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Abstract:
Sorafenib, an oral multikinase inhibitor, is approved for advanced hepatocellular carcinoma (HCC) treatment. However, its therapeutic effect in advanced HCC patients with extrahepatic metastasis remains uncertain. This study aimed to prospectively assess the efficacy, safety, and survival risk factors and evaluate the prognostic impact of sorafenib treatment in advanced HCC patients with or without extrahepatic metastasis. Between May 2009 and March 2014, 312 consecutive advanced HCC patients who received sorafenib were enrolled in this study. We evaluated their characteristics and compared the clinical outcomes of those with and without extrahepatic metastasis. Of the enrolled patients, 245 (81%) received sorafenib treatment for more than 1 month, with a median duration of 3.6 months. Eighteen patients demonstrated partial response to sorafenib therapy, 127 had stable disease, and 134 had progressive disease at the first radiologic assessment. The median survival time (MST) and progression-free survival (PFS) were 10.3 and 3.6 months, respectively. Multivariate analysis identified gender, Child-Pugh class, baseline serum des-gamma-carboxy prothrombin level, and treatment duration as independent risk factors for survival. Extrahepatic metastasis was detected in 178 patients. However, the MST, PFS, and therapeutic effect were comparable between patients with and without extrahepatic metastasis. The independent risk factors for decreased overall survival in patients with extrahepatic metastasis were similar to those affecting all patients. Our results indicated that sorafenib could be administered for hepatic reserve and as long-term treatment for advanced HCC patients regardless of their extrahepatic metastasis status.

Keywords:
Extrahepatic metastasis; hepatic reserve; hepatocellular carcinoma; long-term treatment; sorafenib

Autoři: Masahito Nakano ¹; Masatoshi Tanaka ²; Ryoko Kuromatsu ¹; Hiroaki Nagamatsu ³; Nobuyoshi Tajiri ¹; Manabu Satani ¹; Takashi Niizeki ¹; Hajime Aino ¹; Shusuke Okamura ¹; Hideki Iwamoto ¹; Shigeo Shimose ¹; Tomotake Shirono ¹; Hironori Koga ¹; Takuji Torimura For The Kurume Liver Cancer Study Group Of Japan ¹
Působiště autorů: Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan ¹; Yokokura Hospital, Miyama, Fukuoka, Japan ²; Yame General Hospital, Yame, Fukuoka, Japan ³
Vyšlo v časopise: Cancer Medicine 2015; Early View(Early View)
Kategorie: Original Research
prolekare.web.journal.doi_sk: https://doi.org/10.1002/cam4.548

Souhrn

Keywords:
Extrahepatic metastasis; hepatic reserve; hepatocellular carcinoma; long-term treatment; sorafenib

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