Abstract
Background and AimsThe multikinase inhibitor sorafenib is the only currently approved drug for the indication of advanced hepatocellular carcinoma (HCC). It provides a limited gain in survival time but is frequently associated with adverse events. We currently lack simple prognostic factors in sorafenib-treated HCC patients. Various inflammation-based scores (IBSs) have been evaluated as predictors of tumor recurrence and survival in various malignancies (including HCC). The objective of the present study was to determine the prognostic value of IBSs for overall survival (OS) in advanced HCC patients prior to the initiation of sorafenib therapy.MethodsPatients with Barcelona Clinic Liver Cancer stage C HCC were enrolled retrospectively between October 2007 and September 2015. To identify prognostic factors for OS, bivariate and multivariate analysis were performed using a Cox proportional hazards regression model.Results161 patients (87.0% males; median age: 67; median OS: 9.1 months) were enrolled. A multivariate analysis identified a body mass index <25kg/m2 (hazard ratio (HR)=1.55, p<0.017), macroscopic vascular invasion (HR=1.63, p< 0.001), an AST level >38 U/L (HR=2.65, p<0.001), Child Pugh B stage (HR=2.59, p<0.001) and a systemic immune-inflammation index (SII) ≥600 × 109 (HR 1.72, p=0.002) as independent risk factors for OS in advanced HCC.ConclusionIBSs (such as the SII) are novel, simple, low-cost prognostic indices in patients with advanced HCC. They may be of value in determining whether these patients may benefit from sorafenib therapy.
Highlights
Hepatocellular carcinoma (HCC) is the sixth most common cancer and the second leading cause of cancer-related death in the world [1]
inflammation-based scores (IBSs) are novel, simple, low-cost prognostic indices in patients with advanced hepatocellular carcinoma (HCC). They may be of value in determining whether these patients may benefit from sorafenib therapy
The objective of the present study was to investigate the prognostic value of pre-treatment IBSs for the overall survival (OS) of advanced HCC patients subsequently treated with sorafenib
Summary
Hepatocellular carcinoma (HCC) is the sixth most common cancer and the second leading cause of cancer-related death in the world [1]. Advanced HCC is a heterogeneous disease; it includes symptomatic tumors and those with an invasive tumor pattern (i.e. macroscopic vascular invasion/extrahepatic spread) [5,6,7]; reliable predictive factors for clinical outcomes in sorafenib-treated patients have yet to be identified [8]. The objective of the present study was to investigate the prognostic value of pre-treatment IBSs for the OS of advanced HCC patients subsequently treated with sorafenib. The multikinase inhibitor sorafenib is the only currently approved drug for the indication of advanced hepatocellular carcinoma (HCC). It provides a limited gain in survival time but is frequently associated with adverse events. The objective of the present study was to determine the prognostic value of IBSs for overall survival (OS) in advanced HCC patients prior to the initiation of sorafenib therapy
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