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Published on: May 24, 2024
Impact of surgical treatment after sorafenib therapy for advanced hepatocellular carcinoma
Hideaki Takeyama1, Toru Beppu1, Takaaki Higashi1
1Department of Gastroenterological Surgery, Kumamoto University Graduate School of Life Sciences, 1-1-1 Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan.
Background:
For advanced hepatocellular carcinoma (HCC), surgical treatment after sorafenib induction has rarely been reported. We examined the survival benefit of additional surgical treatment in sorafenib-treated patients.
Methods:
Thirty-two advanced HCC patients were given sorafenib from July 2009 to July 2012, and we statistically analyzed the relevant predictive factors of the long-term survival. The institutional review board of Kumamoto University Hospital approved this study (Approval number 1038).
Results:
The median duration of sorafenib administration was 56.5 days (range 5-945). The cumulative overall survival rate was 44.6, 33.4, 26.0 and 17.8% at 1, 2, 3 and 5 years, respectively. The median survival time was 11.2 months. A survival of more than 3 years after the initiation of sorafenib induction was observed in seven patients, five of whom were subjected to additional surgical intervention. Additional surgery was the most significant factor predicting a survival exceeding 3 years (P < 0.0001) and represents an independent prognostic factor [hazard ratio (HR) 0.07; P = 0.01], followed by the total dose of sorafenib. The surgical interventions comprised two hepatic resections ± radiofrequency ablation, two radiofrequency ablations and one lung resection.
Conclusions:
A long-term survival might be obtained for select HCC patients given adequate additional surgical treatment, even after sorafenib induction.
