Kazuomi Ueshima1, Sadahisa Ogasawara2,3, Masafumi Ikeda4, Yutaka Yasui5, Takeshi Terashima6,7, Tatsuya Yamashita6,7, Shuntaro Obi8,9, Shinpei Sato9, Hiroshi Aikata10, Takumi Ohmura11, Hidekatsu Kuroda12, Takamasa Ohki13, Kengo Nagashima14, Yoshihiko Ooka2, Masahiro Takita1, Masayuki Kurosaki5, Kazuaki Chayama10, Shuichi Kaneko6, Namiki Izumi5, Naoya Kato2,3, Masatoshi Kudo1, Masao Omata15,16. 1. Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan. 2. Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan. 3. Translational Research and Development Center, Chiba University Hospital, Chiba, Japan. 4. Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan. 5. Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Musashino, Japan. 6. Department of Gastroenterology, Kanazawa University Hospital, Kanazawa, Japan. 7. Advanced Preventive Medical Sciences Research Center, Kanazawa University, Kanazawa, Japan. 8. Third Department of Internal Medicine, Teikyo University School of Medicine, Ichihara, Japan. 9. Department of Gastroenterology and Hepatology, Kyoundo Hospital of the Sasaki Institute, Tokyo, Japan. 10. Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan. 11. Department of Gastroenterology, Sapporo Kosei General Hospital, Sapporo, Japan. 12. Division of Hepatology, Department of Internal Medicine, Iwate Medical University, Morioka, Japan. 13. Department of Gastroenterology, Mitsui Memorial Hospital, Tokyo, Japan. 14. Research Center for Medical and Health Data Science, The Institute of Statistical Mathematics, Tokyo, Japan. 15. Yamanashi Prefectural Central Hospital, Kofu, Japan. 16. The University of Tokyo, Tokyo, Japan.
Abstract
BACKGROUND: Prior to the approval of sorafenib, hepatic arterial infusion chemotherapy (HAIC) was offered to patients with advanced hepatocellular carcinoma (HCC) in East Asia, particularly Japan. According to the Japanese guidelines, HAIC is recommended as one of the treatment options in patients without extrahepatic metastasis (EHM). METHODS: The present cohort study compared the use of HAIC and sorafenib on outcomes of patients with advanced HCC. Consecutive patients with advanced HCC who received HAIC or sorafenib as a first-line systemic therapy were enrolled from 10 Japanese institutions. The primary outcomes were overall survival (OS) in patients with macrovascular invasion (MVI), but without EHM, and OS in patients without both MVI and EHM. RESULTS: Between 2009 and 2016, 2,006 patients were enrolled (541 HAIC patients, 1,465 sorafenib patients). After propensity score matching, the OS of patients with MVI but without EHM was significantly longer in the HAIC group compared with the sorafenib group (10.1 vs. 9.1 months for the HAIC and sorafenib groups, respectively; n = 170 for each group; hazard ratio [HR] 0.668; 95% confidence interval [95% CI] 0.475-0.935; p = 0.018). There was no significant difference in OS between patients without both MVI and EHM (12.2 vs. 15.4 months for the HAIC and sorafenib groups, respectively; n = 76 in each cohort after propensity score matching; HR 1.227; 95% CI 0.699-2.155; p = 0.475). CONCLUSION: HAIC is a potential front-line treatment choice in a subpopulation of patients with advanced HCC with MVI but without EHM.
BACKGROUND: Prior to the approval of sorafenib, hepatic arterial infusion chemotherapy (HAIC) was offered to patients with advanced hepatocellular carcinoma (HCC) in East Asia, particularly Japan. According to the Japanese guidelines, HAIC is recommended as one of the treatment options in patients without extrahepatic metastasis (EHM). METHODS: The present cohort study compared the use of HAIC and sorafenib on outcomes of patients with advanced HCC. Consecutive patients with advanced HCC who received HAIC or sorafenib as a first-line systemic therapy were enrolled from 10 Japanese institutions. The primary outcomes were overall survival (OS) in patients with macrovascular invasion (MVI), but without EHM, and OS in patients without both MVI and EHM. RESULTS: Between 2009 and 2016, 2,006 patients were enrolled (541 HAIC patients, 1,465 sorafenib patients). After propensity score matching, the OS of patients with MVI but without EHM was significantly longer in the HAIC group compared with the sorafenib group (10.1 vs. 9.1 months for the HAIC and sorafenib groups, respectively; n = 170 for each group; hazard ratio [HR] 0.668; 95% confidence interval [95% CI] 0.475-0.935; p = 0.018). There was no significant difference in OS between patients without both MVI and EHM (12.2 vs. 15.4 months for the HAIC and sorafenib groups, respectively; n = 76 in each cohort after propensity score matching; HR 1.227; 95% CI 0.699-2.155; p = 0.475). CONCLUSION: HAIC is a potential front-line treatment choice in a subpopulation of patients with advanced HCC with MVI but without EHM.
Authors: Lindsey A Torre; Freddie Bray; Rebecca L Siegel; Jacques Ferlay; Joannie Lortet-Tieulent; Ahmedin Jemal Journal: CA Cancer J Clin Date: 2015-02-04 Impact factor: 508.702
Authors: Josep M Llovet; Sergio Ricci; Vincenzo Mazzaferro; Philip Hilgard; Edward Gane; Jean-Frédéric Blanc; Andre Cosme de Oliveira; Armando Santoro; Jean-Luc Raoul; Alejandro Forner; Myron Schwartz; Camillo Porta; Stefan Zeuzem; Luigi Bolondi; Tim F Greten; Peter R Galle; Jean-François Seitz; Ivan Borbath; Dieter Häussinger; Tom Giannaris; Minghua Shan; Marius Moscovici; Dimitris Voliotis; Jordi Bruix Journal: N Engl J Med Date: 2008-07-24 Impact factor: 91.245