Clinical characteristics of long-term survivors following sorafenib treatment for unresectable hepatocellular carcinoma: Korean national multicenter retrospective cohort studyopen access
- Authors
- Cho, Young Youn; Kim, Do Young; Paik, Yong-Han; Bae, Si Hyun; Park, Su Cheol; Kim, Kang Mo; Jang, Eun Sun; Kim, In Hee; Kim, Hyung Jun; Kim, Yoon Jun
- Issue Date
- Nov-2018
- Publisher
- WILEY
- Keywords
- good responder; prognosis; sorafenib; survivor
- Citation
- JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, v.33, pp 69 - 69
- Pages
- 1
- Journal Title
- JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
- Volume
- 33
- Start Page
- 69
- End Page
- 69
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/63826
- DOI
- 10.2147/JHC.S304439
- ISSN
- 0815-9319
1440-1746
- Abstract
- Background/Aim: Sorafenib is the first systemic therapy for the treatment of advanced-stage hepatocellular carcinoma (HCC) and progressive HCC after locoregional therapy. The aim of this study was to evaluate the prognostic factors of long-term survivors after sorafenib treatment. Methods: This multicenter, retrospective, cohort study included 1,566 unresectable HCC patients who received sorafenib treatment between 2007 and 2014 in nine tertiary centers in Korea. The patients were classified into a long-term survivor group (survival more than two years, n = 257) or a control group (n = 1309). The primary outcomes were the prognostic factors affecting long-term survival. Secondary endpoints included time-to-progression and other safety profiles. Results: The patients were predominantly men (83.8%) with chronic hepatitis B (77.3%) and Barcelona clinic of liver cancer-stage C (BCLC-C) (78.3%). The median overall survival was 9.0 months. After treatment, eight patients (0.4%) achieved complete response and 139 patients (8.8%) achieved partial response according to the mRECIST criteria. The prognostic factors predicting long-term survival were metformin use (adjusted hazard ratio [aHR] = 3.464; P < 0.001), hand-foot skin reaction (aHR = 1.688; P = 0.003), and concomitant treatment with chemoembolization or radiotherapy (aHR = 2.766; P < 0.001). Poor prognostic factors of long-term survival were a Child-Pugh score of B (HR = 0.422; P < 0.001), the presence of extrahepatic metastasis (HR = 0.639; P = 0.005), main portal vein invasion (HR = 0.502; P = 0.001), and elevated alpha-fetoprotein (>1,000 ng/mL; HR = 0.361; P < 0.001). Conclusion: This large, multicenter, retrospective study showed an objective response rate of 9.1% and a proportion of long-term survivors of 16.4% in Korean patients. The prognostic factors derived in our study can be used in clinical practice during sorafenib treatment.
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