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Comparison of clinical outcome of hepatic arterial infusion chemotherapy and sorafenib for advanced hepatocellular carcinoma according to macrovascular invasion and transcatheter arterial chemoembolization refractory status
Author(s) -
Kodama Kenichiro,
Kawaoka Tomokazu,
Aikata Hiroshi,
Uchikawa Shinsuke,
Inagaki Yuki,
Hatooka Masahiro,
Morio Kei,
Nakahara Takashi,
Murakami Eisuke,
Tsuge Masataka,
Hiramatsu Akira,
Imamura Michio,
Kawakami Yoshiiku,
Masaki Keiichi,
Honda Yoji,
Mori Nami,
Takaki Shintaro,
Tsuji Keiji,
Kohno Hirotaka,
Kohno Hiroshi,
Moriya Takashi,
aka Michihiro,
Hyogo Hideyuki,
Aisaka Yasuyuki,
Chayama Kazuaki
Publication year - 2018
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.14152
Subject(s) - medicine , sorafenib , hepatocellular carcinoma , refractory (planetary science) , transcatheter arterial chemoembolization , gastroenterology , univariate analysis , chemotherapy , multivariate analysis , metastasis , oncology , surgery , cancer , physics , astrobiology
Background and Aim Sorafenib is the standard treatment for patients with advanced hepatocellular carcinoma (HCC) with distant metastasis, unresectable HCC, and HCC refractory to transcatheter arterial chemoembolization (TACE) or with macroscopic vascular invasion (MVI). Also, hepatic arterial infusion chemotherapy (HAIC) has been used for advanced HCC in Southeast and East Asian countries. However, clearer information is needed for choosing appropriately between these therapies. Methods The subjects were 391 HAIC and 431 sorafenibs administered at our hospital and related hospitals. In this case, cases that satisfy the following three conditions were targeted: (i) no extrahepatic metastasis, (ii) Child‐Pugh A, and (ii) not having received treatment of both HAIC and sorafenib during the course. As a result, 150 cases of HAIC and 134 cases of sorafenib were analyzed this time. Results Univariate and multivariate analyses were performed for the HAIC and sorafenib groups. TACE refractory status and MVI were factors contributing to overall survival (OS). Therefore, this study divided all cases according to those variables. The median survival time of MVI‐positive and non‐TACE refractory cases was significantly better with HAIC (13 months) versus sorafenib (6 months). However, in MVI‐negative and TACE refractory cases, the median survival time of HAIC (8 months) was significantly poorer than for sorafenib (20 months). Conclusion Transcatheter arterial chemoembolization refractory status with HAIC and MVI with sorafenib were factors for poor prognosis. In particular, HAIC was significantly better than sorafenib as primary treatment in MVI and non‐TACE refractory cases. It is necessary to consider these factors in treatment selection.