Abstract
BackgroundTreatment outcomes of sorafenib therapy may greatly vary depending not only on tumor spread but also on past clinical processes prior to sorafenib therapy and timing of sorafenib administration in the past clinical course of hepatocellular carcinoma (HCC). We evaluated the efficacy of sorafenib in patients with HCC, taking into account of their past clinical courses.MethodsPatients with HCC treated with sorafenib as a first-line systemic therapy, whose courses documented from the time of the initial diagnosis, were retrospectively analyzed.ResultsOf the 123 patients receiving sorafenib therapy at an advanced-stage, baseline characteristics differed including the rate of hepatitis C virus, Child–Pugh class, and status of intrahepatic lesions according to stage progression processes. Overall survival (OS) in patients progressed directly from the early-stage (15.3 months) was significantly longer than that in patients diagnosed at the advanced-stage (5.3 months, P = 0.022) and progressed from the intermediate-stages (6.0 months, P = 0.041). Of 105 patients diagnosed at the intermediate-stage on past clinical courses, OS of starting sorafenib therapy before progression to the advanced-stage (67 patients) was significantly longer than for patients starting sorafenib therapy only after progression to the advanced-stage (38 patients) (P = 0.015).ConclusionCharacteristic differences between past stage progression processes might affect prognosis in advanced-stage HCC patients receiving sorafenib. Switching to sorafenib therapy before progression to the advanced-stage appears more effective than that after progression to the advanced-stage in patients diagnosed in the intermediate-stage on past clinical courses prior to sorafenib administration.
Highlights
Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related deaths and the 16th overall cause of deaths globally [1]
Of the 123 patients receiving sorafenib therapy at an advanced-stage, baseline characteristics differed including the rate of hepatitis C virus, Child–Pugh class, and status of intrahepatic lesions according to stage progression processes
Of 105 patients diagnosed at the intermediate-stage on past clinical courses, Overall survival (OS) of starting sorafenib therapy before progression to the advanced-stage (67 patients) was significantly longer than for patients starting sorafenib therapy only after progression to the advanced-stage (38 patients) (P = 0.015)
Summary
Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related deaths and the 16th overall cause of deaths globally [1]. According to data from the surveillance of high-risk populations, numerous patients are diagnosed with early-stage HCC and are eligible for potentially curative therapies, which include liver resection or local ablation [3,4,5,6]. Treatment with TACE for intermediate-stage HCC is associated with an estimated median survival of 26.1–27.8 months [10, 11]. Repeated TACE promotes resistance and increases the chance of tumor recurrence and progression to the advanced-stage. Treatment outcomes of sorafenib therapy may greatly vary depending on tumor spread and on past clinical processes prior to sorafenib therapy and timing of sorafenib administration in the past clinical course of hepatocellular carcinoma (HCC). We evaluated the efficacy of sorafenib in patients with HCC, taking into account of their past clinical courses
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