Martha M Kirstein1, Torsten Voigtländer1, Nora Schweitzer1, Jan B Hinrichs2, Jens Marquardt3, Marcus-Alexander Wörns3, Roman Kloeckner4, Thorben W Fründt5, Harald Ittrich6, Frank Wacker2, Thomas Rodt2, Michael P Manns1, Henning Wege5, Arndt Weinmann3, Arndt Vogel1. 1. Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany. 2. Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany. 3. Department of Internal Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany. 4. Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg, Mainz, Germany. 5. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 6. Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Abstract
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.
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.
Authors: J M Llovet; J Bustamante; A Castells; R Vilana; M del C Ayuso; M Sala; C Brú; J Rodés; J Bruix Journal: Hepatology Date: 1999-01 Impact factor: 17.425
Authors: Giuseppe Cabibbo; Marcello Maida; Chiara Genco; Pietro Parisi; Marco Peralta; Michela Antonucci; Giuseppe Brancatelli; Calogero Cammà; Antonio Craxì; Vito Di Marco Journal: World J Hepatol Date: 2012-09-27