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Clinical outcome and prognostic factors of patients with hepatocellular carcinoma and extrahepatic metastasis treated with sorafenib
Author(s) -
Kawaoka Tomokazu,
Aikata Hiroshi,
Kan Hiromi,
Fujino Hatsue,
Fukuhara Takayuki,
Kobayashi Tomoki,
Naeshiro Noriaki,
Miyaki Daisuke,
Hiramatsu Akira,
Imamura Michio,
Kawakami Yoshiiku,
Hyogo Hideyuki,
Chayama Kazuaki
Publication year - 2014
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12307
Subject(s) - medicine , sorafenib , hepatocellular carcinoma , gastroenterology , stage (stratigraphy) , oncology , metastasis , progressive disease , response evaluation criteria in solid tumors , cohort , intrahepatic cholangiocarcinoma , disease , cancer , paleontology , biology
Aim The purpose of this study was to assess the clinical outcome and identify prognostic factors following treatment of patients with advanced hepatocellular carcinoma ( HCC ) and extrahepatic metastasis with sorafenib. Methods Sixty‐one HCC patients with extrahepatic metastasis who were treated with sorafenib were enrolled in this retrospective cohort study. Results The median survival time ( MST ) of all patients was 11 months. The median time to radiological progression was 4.2 months. The response rates (complete response [ CR ] + partial response [ PR ]) by R esponse E valuation C riteria in S olid T umors ( RECIST ) and modified RECIST were 3.0% and 8.0%, respectively, while the disease control rates ( CR + PR + stable disease) were 49% and 49%, respectively. Multivariate analysis identified T factor (intrahepatic tumor stage, T 0–2), response to disease control and des‐γ‐carboxy prothrombin (<2600 mAU/mL) as significant and independent determinants of survival. Intrahepatic tumor stage before treatment allows stratification of prognosis of patients treated with sorafenib. Four T 0 patients remained alive. The MST of patients with T 1 ( n = 6), T 2 ( n = 10), T 3 ( n = 23) and T 4 ( n = 18) of intrahepatic tumor stage was 20, 23, 7 and 5 months, respectively. Among the progressive disease group, patients with T 0–2 intrahepatic tumor stage had better prognosis than patients with T 3–4. Conclusion In HCC patients with extrahepatic metastasis who are treated with sorafenib, intrahepatic tumor stage was a significant and independent prognostic factor.