BACKGROUND: Sorafenib is the only approved agent recommended by the American Association Study of Liver Disease guidelines for hepatocellular carcinoma patients in Barcelona Clinic Liver Cancer stage C. AIMS: To calculate and compare overall survival rates in hepatocellular carcinoma patients in Barcelona Clinic Liver Cancer stage C treated with various therapies or supportive care alone. METHODS: This was a retrospective study, in which medical data from 411 newly diagnosed hepatocellular carcinoma patients in Barcelona Clinic Liver Cancer stage C and Child-Pugh class A were analyzed and compared. RESULTS: Eighty-eight patients were treated with supportive care and 323 were treated with surgical resection (68/323, 21.1%), local ablation therapy (8/323, 2.5%), transarterial embolization (140/323, 43.3%), systemic chemotherapy or radiotherapy (96/323, 29.7%), and sorafenib (11/323, 3.4%). Median survival was 11 months (95% confidence interval, 9.0-13.1) in treated patients compared with 3.9 months in the supportive care group (hazard ratio, 0.45; 95% confidence interval, 0.35-0.59; p<0.001). Patients who underwent surgical resection had the longest survival compared to patients undergoing other treatments (33.4 months versus 8.1 months, p<0.001). CONCLUSIONS: Surgical resection resulted in excellent outcomes. Although sorafenib is currently recommended, oncologists should endeavour to select optimal candidates for surgical resection to gain more survival benefit.
BACKGROUND:Sorafenib is the only approved agent recommended by the American Association Study of Liver Disease guidelines for hepatocellular carcinomapatients in Barcelona Clinic Liver Cancer stage C. AIMS: To calculate and compare overall survival rates in hepatocellular carcinomapatients in Barcelona Clinic Liver Cancer stage C treated with various therapies or supportive care alone. METHODS: This was a retrospective study, in which medical data from 411 newly diagnosed hepatocellular carcinomapatients in Barcelona Clinic Liver Cancer stage C and Child-Pugh class A were analyzed and compared. RESULTS: Eighty-eight patients were treated with supportive care and 323 were treated with surgical resection (68/323, 21.1%), local ablation therapy (8/323, 2.5%), transarterial embolization (140/323, 43.3%), systemic chemotherapy or radiotherapy (96/323, 29.7%), and sorafenib (11/323, 3.4%). Median survival was 11 months (95% confidence interval, 9.0-13.1) in treated patients compared with 3.9 months in the supportive care group (hazard ratio, 0.45; 95% confidence interval, 0.35-0.59; p<0.001). Patients who underwent surgical resection had the longest survival compared to patients undergoing other treatments (33.4 months versus 8.1 months, p<0.001). CONCLUSIONS: Surgical resection resulted in excellent outcomes. Although sorafenib is currently recommended, oncologists should endeavour to select optimal candidates for surgical resection to gain more survival benefit.
Authors: Jian-Hong Zhong; A Chapin Rodríguez; Yang Ke; Yan-Yan Wang; Lin Wang; Le-Qun Li Journal: Medicine (Baltimore) Date: 2015-01 Impact factor: 1.889