Abstract
Simple SummaryThus far, clinical studies have shown that immunotherapy (atezolizumab-bevacizumab) has shown better and favorable overall survival than sorafenib for advanced hepatocellular carcinoma (HCC). However, the treatment outcomes of hepatic arterial infusion chemotherapy (HAIC) with cisplatin compared with sorafenib for intrahepatic advanced HCC remain unclear. We therefore aimed to determine the prognostic factors for HAIC with cisplatin. Our results showed that HAIC with cisplatin could significantly prolong the overall survival for intrahepatic advanced HCC and had a longer prognostic effect than sorafenib. Therefore, our results suggest that HAIC should be used in intrahepatic advanced HCC.Given that the outcome of hepatic arterial infusion chemotherapy (HAIC) with cisplatin for intrahepatic advanced hepatocellular carcinoma (HCC) is unclear, we aimed to compare prognostic factors for overall survival (OS) following HAIC with cisplatin versus sorafenib for intrahepatic advanced HCC using propensity score-matched analysis. We enrolled 331 patients with intrahepatic advanced HCC who received HAIC with cisplatin (n = 88) or sorafenib (n = 243) between June 2006 and March 2020. No significant difference was observed in OS between HAIC with cisplatin and sorafenib cohorts (median survival time [MST]: 14.0 vs. 12.3 months; p = 0.0721). To reduce confounding effects, 166 patients were selected using propensity score-matched analysis (n = 83 for each treatment). HAIC with cisplatin significantly prolonged OS compared with sorafenib (MST: 15.6 vs. 11.0 months; p = 0.0157). Following stratification according to the Child-Pugh classification, for patients with class A (MST: 24.0 vs. 15.0 months; p = 0.0145), HAIC with cisplatin rather than sorafenib significantly prolonged OS. Our findings suggest that HAIC with cisplatin demonstrates longer prognostic effects than sorafenib in intrahepatic advanced HCC.
Highlights
Liver cancer was the sixth most commonly diagnosed cancer and the fourth leading cause of cancer-related deaths worldwide in 2018, with an estimated 841,000 new cases and782,000 deaths [1,2,3,4]
A higher proportion of patients tested positive for the hepatitis C virus (p = 0.0196) and had Child-Pugh class B (p = 0.0013) in the hepatic arterial infusion chemotherapy (HAIC) with cisplatin cohort, whereas a higher proportion of patients had macrovascular invasion (p = 0.0233) in the sorafenib cohort
Age; sex; Barcelona Clinic Liver Cancer (BCLC) stage; and total bilirubin, AFP, and des-gamma-carboxy prothrombin (DCP) levels were equivalent between the HAIC with cisplatin and sorafenib cohorts
Summary
Liver cancer was the sixth most commonly diagnosed cancer and the fourth leading cause of cancer-related deaths worldwide in 2018, with an estimated 841,000 new cases and782,000 deaths [1,2,3,4]. Liver cancer was the sixth most commonly diagnosed cancer and the fourth leading cause of cancer-related deaths worldwide in 2018, with an estimated 841,000 new cases and. Early-stage HCC may be curable radically via hepatic resection, radiofrequency ablation, or liver transplantation; patients with advanced HCC have a poor prognosis [5,6]. Hepatic arterial infusion chemotherapy (HAIC) is a treatment option for advanced. HAIC can increase the concentrations of the anticancer drug in the liver and reduce the occurrence of systemic adverse events caused by the anticancer drug [8]. There has been accumulating evidence regarding the efficacy of HAIC for treating advanced HCC [9,10,11]
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