BACKGROUND: Since the approval of sorafenib, no other agent has been proven to show survival benefits in clinical trials involving patients with advanced hepatocellular carcinoma (HCC) resistant to sorafenib. Prognostic factors for survival after tumor progression in sorafenib-treated patients are critical for designing second-line trials. METHODS: To determine the factors affecting the post-progression survival (PPS) after sorafenib treatment, additional analyses were conducted using fixed data obtained from our previous prospective study. Data on patients with advanced HCC treated with sorafenib were analyzed in view of patient characteristics at the time of tumor progression and the progression pattern (intra-/extrahepatic growth or emergence of new intra-/extrahepatic lesions). RESULTS: Of the 89 enrolled patients, 70 were diagnosed with disease progression according to the Response Evaluation Criteria in Solid Tumors version 1.1. Multivariate Cox's regression analysis revealed that Child-Pugh scores of ≥7, macrovascular invasion (MVI), and alpha-fetoprotein of >400 ng/mL were independent predictors of poor PPS. Although both extrahepatic metastasis (EHM) and MVI were characteristics of advanced HCC, EHM was not determined as a prognostic factor. Additionally, the emergence of new extrahepatic lesions also served as an independent indicator of a poor prognosis. The PPS of the patients was well stratified according to the index based on the sum of these prognostic factors, ranging from 0 to 4. CONCLUSIONS: Child-Pugh score of ≥7, AFP of >400 ng/mL, MVI, and new extrahepatic lesions at the time of progression may be utilized to assess the prognosis and taken into consideration when designing second-line trials.
BACKGROUND: Since the approval of sorafenib, no other agent has been proven to show survival benefits in clinical trials involving patients with advanced hepatocellular carcinoma (HCC) resistant to sorafenib. Prognostic factors for survival after tumor progression in sorafenib-treated patients are critical for designing second-line trials. METHODS: To determine the factors affecting the post-progression survival (PPS) after sorafenib treatment, additional analyses were conducted using fixed data obtained from our previous prospective study. Data on patients with advanced HCC treated with sorafenib were analyzed in view of patient characteristics at the time of tumor progression and the progression pattern (intra-/extrahepatic growth or emergence of new intra-/extrahepatic lesions). RESULTS: Of the 89 enrolled patients, 70 were diagnosed with disease progression according to the Response Evaluation Criteria in Solid Tumors version 1.1. Multivariate Cox's regression analysis revealed that Child-Pugh scores of ≥7, macrovascular invasion (MVI), and alpha-fetoprotein of >400 ng/mL were independent predictors of poor PPS. Although both extrahepatic metastasis (EHM) and MVI were characteristics of advanced HCC, EHM was not determined as a prognostic factor. Additionally, the emergence of new extrahepatic lesions also served as an independent indicator of a poor prognosis. The PPS of the patients was well stratified according to the index based on the sum of these prognostic factors, ranging from 0 to 4. CONCLUSIONS:Child-Pugh score of ≥7, AFP of >400 ng/mL, MVI, and new extrahepatic lesions at the time of progression may be utilized to assess the prognosis and taken into consideration when designing second-line trials.
Authors: Massimo Iavarone; Giuseppe Cabibbo; Marco Biolato; Cristina Della Corte; Marcello Maida; Marco Barbara; Michele Basso; Sara Vavassori; Antonio Craxì; Antonio Grieco; Carlo Cammà; Massimo Colombo Journal: Hepatology Date: 2015-03-20 Impact factor: 17.425
Authors: Andrew X Zhu; Masatoshi Kudo; Eric Assenat; Stéphane Cattan; Yoon-Koo Kang; Ho Yeong Lim; Ronnie T P Poon; Jean-Frederic Blanc; Arndt Vogel; Chao-Long Chen; Etienne Dorval; Markus Peck-Radosavljevic; Armando Santoro; Bruno Daniele; Junji Furuse; Annette Jappe; Kevin Perraud; Oezlem Anak; Dalila B Sellami; Li-Tzong Chen Journal: JAMA Date: 2014-07-02 Impact factor: 56.272
Authors: Manuel de la Torre-Aláez; Carlota Jordán-Iborra; Andrea Casadei-Gardini; José Ignacio Bilbao; Macarena Rodriguez-Fraile; Lidia Sancho; Delia D'Avola; José Ignacio Herrero; Mercedes Iñarrairaegui; Bruno Sangro Journal: Cardiovasc Intervent Radiol Date: 2020-03-12 Impact factor: 2.740
Authors: Kerstin Schütte; Regina Schinner; Mathias P Fabritius; Melina Möller; Christiane Kuhl; Roberto Iezzi; Osman Öcal; Maciej Pech; Bora Peynircioglu; Max Seidensticker; Rohini Sharma; Daniel Palmer; Jean-Pierre Bronowicki; Peter Reimer; Peter Malfertheiner; Jens Ricke Journal: Liver Cancer Date: 2020-11-11 Impact factor: 11.740