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Prognostic factors of sorafenib therapy in hepatocellular carcinoma patients with failure of transarterial chemoembolization

 Sangheun Lee  ;  Jung Hyun Kang  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Jun Yong Park  ;  Beom Kyung Kim  ;  Seung Up Kim  ;  Kwang-Hyub Han 
 HEPATOLOGY INTERNATIONAL, Vol.11(3) : 292-299, 2017 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular/drug therapy* ; Carcinoma, Hepatocellular/pathology ; Chemoembolization, Therapeutic/methods ; Disease Progression ; Disease-Free Survival ; Female ; Humans ; Liver Neoplasms/drug therapy* ; Liver Neoplasms/pathology ; Male ; Middle Aged ; Neoplasm Invasiveness ; Niacinamide/administration & dosage ; Niacinamide/adverse effects ; Niacinamide/analogs & derivatives* ; Niacinamide/pharmacology ; Phenylurea Compounds/administration & dosage ; Phenylurea Compounds/adverse effects ; Phenylurea Compounds/pharmacology* ; Portal Vein/pathology* ; Prognosis ; Protein Kinase Inhibitors/therapeutic use ; Retrospective Studies ; Treatment Failure ; Treatment Outcome
Hepatocellular carcinoma ; Overall survival ; Prognosis ; Sorafenib ; Transarterial chemoembolization
BACKGROUND: There is no approved therapy for patients with failed transarterial chemoembolization (TACE) and progression of hepatocellular carcinoma. We aimed to investigate the efficacy and prognostic factors in patients with TACE failure who received sorafenib rescue therapy. METHODS: We investigated 54 patients who met the criteria of TACE failure as defined by the international guidelines of Europe and Japan. Sorafenib was used as a rescue therapy. Overall survival (OS) and progression-free survival (PFS) were analyzed by Kaplan-Meier methods, and multivariate analysis was performed to find prognostic factors. RESULTS: The patients were followed for a median 5.5 months, and the median duration of sorafenib administration was 3.3 months. The presence of main (or lobar) portal vein invasion (PVI) (3.7 versus 8.4 months, p = 0.004), dose reduction of sorafenib (4.0 versus 8.8 months, p = 0.002) and Child-Pugh class B (5.3 versus 8.9 months, p = 0.004) were associated with shorter OS compared to the presence of segmental PVI (or absence of macroscopic vascular invasion, MVI), full dosage of sorafenib and Child-Pugh class A, respectively. The presence of main (or lobar) PVI was associated with poorer PFS compared to the presence of segmental PVI (or absence of MVI) (2.1 versus 3.8 months p = 0.010). CONCLUSIONS: Sorafenib is a potential rescue therapy in patients with TACE failure. However, the clinical benefits need to be further evaluated for patients with main (or lobar) PVI or those treated with reduced doses of sorafenib.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
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