Sorafenib for advanced hepatocellular carcinoma provides better prognosis after liver transplantation than without liver transplantation
Soon Kyu Lee, Jeong Won Jang, Heechul Nam, Pil Soo Sung, Hee Yeon Kim, Jung Hyun Kwon, Sung Won Lee, Do Seon Song, Chang Wook Kim, Myeong Jun Song, Ho Joong Choi, Young Kyoung You, Si Hyun Bae, Jong Young Choi & Seung Kew Yoon
Hepatology International volume 15, pages137–145(2021)Cite this article
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Abstract
Background
Although sorafenib has been used to treat advanced hepatocellular carcinoma (HCC), the efficacy of sorafenib in patients with recurrent HCCs after liver transplantation (LT) has not been compared with that in patients without LT (non-LT).
Methods
Between 2008 and 2019, a total of 832 consecutive HCC patients treated with sorafenib (790 in the non-LT group and 42 in the LT group) were enrolled. The primary outcome was overall survival (OS). Secondary outcomes were time-to-progression (TTP), objective response rate (ORR) and disease control rate (DCR). Treatment outcomes were assessed by multiple subgroup analyses and propensity-score matching (PSM).
Results
The median follow-up duration was 152.5 days. The LT group was younger and had smaller intrahepatic HCC than the non-LT group. The LT group showed significantly better OS (16.8 vs. 7.1 months, p < 0.001), TTP, ORR and DCR than the non-LT group. The superior efficacy of sorafenib in the LT group was corroborated in multiple subgroup analyses stratified by metastasis, effective sorafenib maintenance dose, or Child-Turcotte-Pugh class A. LT was identified as an independent factor for favorable OS. Intrahepatic HCC was the strongest tumor-related factor for both OS and TTP and was significantly associated with tumor response and hepatic function. Finally, subanalyses including only patients with small intrahepatic HCC or PSM modeling showed no difference in sorafenib efficacy between the LT and the non-LT groups.
Conclusion
Sorafenib provides better outcomes in the LT setting than the non-LT setting. This benefit may be associated with the smaller intrahepatic HCC coupled with preserved hepatic function in LT recipients.作者: StephenW 时间: 2021-2-18 18:38
索拉非尼用于晚期肝细胞癌的肝移植预后比未进行肝移植的预后好
很快，李圭圭，郑远章，Heechul Nam，Pil Soo Sung，熙妍金，郑贤权，宋媛媛，杜善嵩，金昌旭，明俊嵩，何钟彩，杨京佑，施贤培，钟荣彩和成邱允