Hideki Iwamoto1,2, Takashi Niizeki1, Hiroaki Nagamatsu3, Kazuomi Ueshima4, Takako Nomura5, Teiji Kuzuya6, Kazuhiro Kasai7, Yohei Kooka8, Atsushi Hiraoka9, Rie Sugimoto10, Takehiro Yonezawa11, Akio Ishihara12, Akihiro Deguchi13, Hirotaka Arai14, Shigeo Shimose1, Tomotake Shirono1, Masahito Nakano1, Shusuke Okamura1, Yu Noda1, Naoki Kamachi1, Miwa Sakai1, Hiroyuki Suzuki1, Hajime Aino15, Norito Matsukuma16, Satoru Matsugaki17, Kei Ogata18, Yoichi Yano19, Takato Ueno20, Masahiko Kajiwara21, Satoshi Itano22, Kunitaka Fukuizumi23, Hiroshi Kawano24, Kazunori Noguchi25, Masatoshi Tanaka26, Taizo Yamaguchi2, Ryoko Kuromatsu1, Atsushi Kawaguchi27, Hironori Koga1, Takuji Torimura1. 1. Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan. 2. Iwamoto Internal Medicine Clinic, Kitakyusyu 802-0832, Japan. 3. Department of Gastroenterology, Juntendo University, Bunkyo-ku 113-8421, Japan. 4. Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka 589-8511, Japan. 5. Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Miki 761-0793, Japan. 6. Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan. 7. Division of Gastroenterology, IMS Sapporo Digestive Disease Center General Hospital, Sapporo 063-0842, Japan. 8. Division of Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Iwate 028-3695, Japan. 9. Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama 790-0024, Japan. 10. Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Fukuoka 811-1395, Japan. 11. Department of Gastroenterology, Hachinohe Red Cross Hospital, Aomori 039-1104, Japan. 12. Department of Gastroenterology, Osaka National Hospital, Osaka 540-0006, Japan. 13. Department of Gastroenterology, Kagawa Rosai Hospital, Marugame 763-8502, Japan. 14. Department of Gastroenterology, Maebashi Red Cross Hospital, Maebashi 371-0811, Japan. 15. Division of Gastroenterology, Department of Medicine, Social Insurance Tagawa Hospital, Tagawa 826-0023, Japan. 16. Department of Gastroenterology, Kurume General Hospital, Kurume 830-8521, Japan. 17. Department of Gastroenterology, Tobata Kyoritsu Hospital, Kitakyusyu 804-0093, Japan. 18. Department of Gastroenterology, Kurume University Medical Center, Kurume 839-0863, Japan. 19. Department of Gastroenterology, Saga Central Hospital, Saga 849-8522, Japan. 20. Department of Gastroenterology, Asakura Medical Association Hospital, Asakura 838-0069, Japan. 21. Department of Gastroenterology, Chikugo City Hospital, Chikugo 833-0041, Japan. 22. Department of Gastroenterology, Kurume Central Hospital, Kurume 830-0001, Japan. 23. Department of Gastroenterology, National Hospital Organization Kyushu Medical Center, Fukuoka 810-8563, Japan. 24. Department of Gastroenterology, St. Mary's Hospital, Kurume 830-8543, Japan. 25. Department of Gastroenterology, Omuta City Hospital, Omuta 836-0861, Japan. 26. Department of Gastroenterology, Yokokura Hospital, Miyama 839-0215, Japan. 27. Center for Comprehensive Community Medicine Faculty of Medicine, Saga University, Saga 840-0027, Japan.
Abstract
BACKROUND: Not all patients with hepatocellular carcinoma (HCC) benefit from treatment with molecular targeted agents such as sorafenib. We investigated whether New-FP (fine-powder cisplatin and 5-fluorouracil), a hepatic arterial infusion chemotherapy regimen, is more favorable than sorafenib as an initial treatment for locally progressed HCC. METHODS: To avoid selection bias, we corrected the data from different facilities that did or did not perform New-FP therapy. In total, 1709 consecutive patients with HCC initially treated with New-FP or sorafenib; 1624 (New-FP, n = 644; sorafenib n = 980) were assessed. After propensity score matching (PSM), overall survival (OS) and prognostic factors were assessed (n = 344 each). Additionally, the patients were categorized into four groups: cohort-1 [(without macrovascular invasion (MVI) and extrahepatic spread (EHS)], cohort-2 (with MVI), cohort-3 (with EHS), and cohort-4 (with MVI and EHS) to clarify the efficacy of each treatment. RESULTS: New-FP prolonged OS than sorafenib after PSM (New-FP, 12 months; sorafenib, 7.9 months; p < 0.001). Sorafenib treatment, and severe MVI and EHS were poor prognostic factors. In the subgroup analyses, the OS was significantly longer the New-FP group in cohort-2. CONCLUSIONS: Local treatment using New-FP is a potentially superior initial treatment compared with sorafenib as a multidisciplinary treatment in locally progressed HCC without EHS.
BACKROUND: Not all patients with hepatocellular carcinoma (HCC) benefit from treatment with molecular targeted agents such as sorafenib. We investigated whether New-FP (fine-powder cisplatin and 5-fluorouracil), a hepatic arterial infusion chemotherapy regimen, is more favorable than sorafenib as an initial treatment for locally progressed HCC. METHODS: To avoid selection bias, we corrected the data from different facilities that did or did not perform New-FP therapy. In total, 1709 consecutive patients with HCC initially treated with New-FP or sorafenib; 1624 (New-FP, n = 644; sorafenib n = 980) were assessed. After propensity score matching (PSM), overall survival (OS) and prognostic factors were assessed (n = 344 each). Additionally, the patients were categorized into four groups: cohort-1 [(without macrovascular invasion (MVI) and extrahepatic spread (EHS)], cohort-2 (with MVI), cohort-3 (with EHS), and cohort-4 (with MVI and EHS) to clarify the efficacy of each treatment. RESULTS: New-FP prolonged OS than sorafenib after PSM (New-FP, 12 months; sorafenib, 7.9 months; p < 0.001). Sorafenib treatment, and severe MVI and EHS were poor prognostic factors. In the subgroup analyses, the OS was significantly longer the New-FP group in cohort-2. CONCLUSIONS: Local treatment using New-FP is a potentially superior initial treatment compared with sorafenib as a multidisciplinary treatment in locally progressed HCC without EHS.
Authors: K Okuda; M Tanaka; J Shibata; E Ando; T Ogata; H Kinoshita; N Eriguchi; S Aoyagi; K Tanikawa Journal: Oncol Rep Date: 1999 May-Jun Impact factor: 3.906
Authors: Richard S Finn; Shukui Qin; Masafumi Ikeda; Peter R Galle; Michel Ducreux; Tae-You Kim; Masatoshi Kudo; Valeriy Breder; Philippe Merle; Ahmed O Kaseb; Daneng Li; Wendy Verret; Derek-Zhen Xu; Sairy Hernandez; Juan Liu; Chen Huang; Sohail Mulla; Yulei Wang; Ho Yeong Lim; Andrew X Zhu; Ann-Lii Cheng Journal: N Engl J Med Date: 2020-05-14 Impact factor: 91.245
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