Open AccessTransarterial chemoembolization versus sorafenib in patients with hepatocellular carcinoma and extrahepatic disease
Author(s) -
Kirstein Martha M,
Voigtländer Torsten,
Schweitzer Nora,
Hinrichs Jan B,
Marquardt Jens,
Wörns MarcusAlexander,
Kloeckner Roman,
Fründt Thorben W,
Ittrich Harald,
Wacker Frank,
Rodt Thomas,
Manns Michael P,
Wege Henning,
Weinmann Arndt,
Vogel Arndt
Publication year - 2018
Publication title -
ueg journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 35
eISSN - 2050-6414
pISSN - 2050-6406
DOI - 10.1177/2050640617716597
Subject(s) - sorafenib , medicine , hepatocellular carcinoma , cirrhosis , gastroenterology , propensity score matching , oncology
Background Sorafenib is the recommended treatment for advanced hepatocellular carcinoma (HCC), but transarterial chemoembolization (TACE) is performed in individual cases with limited extrahepatic spread. The aim of this study was to compare the outcome of patients with HCC and extrahepatic disease (EHD) treated with sorafenib and TACE. Methods A total of 172 patients with HCC and EHD treated with sorafenib ( n = 98) or TACE ( n = 74) at three German referral centers (Hannover, Mainz and Hamburg) were included in this study. In order to reduce selection bias, patients were matched for significant demographic differences using a propensity score analysis. Results Patients with liver cirrhosis, higher extrahepatic tumor burden and/or infiltration of adjacent organs/structures were significantly more often treated with sorafenib. Median overall survival (OS) was similar for sorafenib‐ and TACE‐treated patients (7 versus 8 months, p = 0.312). In a propensity score analysis matched for demographic differences, median OS remained similar with 4 versus 8 months for sorafenib versus TACE ( p = 0.613). Conclusion Treatment with TACE is not inferior to treatment with sorafenib in patients with limited EHD of HCC. TACE represents an effective therapeutic option in selected patients with EHD.