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Adjuvant sorafenib therapy in patients with resected hepatocellular carcinoma: evaluation of predictive factors

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Abstract

Currently there is no predictor for survival after adjuvant sorafenib in patients with hepatocellular carcinoma (HCC) who have undergone curative resection. Thirty-eight patients who underwent curative resection of HCC received adjuvant sorafenib therapy between August 2009 and March 2012. Clinicopathological parameters including patient factors, tumor factors, liver background, and inflammatory factors (before surgery and dynamic changes after sorafenib therapy) were evaluated to identify predictors for overall survival (OS) and recurrence-free survival (RFS). The recurrence rate, mortality rate, and clinicopathological data were also compared. Increased NLR after sorafenib (HR = 3.199, 95 % CI 1.365–7.545, P = 0.008), increased GGT after sorafenib (HR = 3.204, 95 % CI 1.333–7.700, P = 0.009), and the presence of portal vein thrombosis (HR = 2.381, 95 % CI 1.064–5.328, P = 0.035) were risk factors related to RFS. By contrast, increased NLR after sorafenib was the only independent risk factor related to OS (HR = 4.647, 95 % CI 1.266–17.053, P = 0.021). Patients with increased NLR or increased GGT after sorafenib had a higher incidence of recurrence and death. Patients who had increased NLR tended to have higher preoperative levels of NLR and GGT. There were no differences in clinicopathological factors in patients with increased GGT and decreased GGT. In conclusion, increased NLR predicted a worse OS and RFS in patients with HCC who underwent curative resection with adjuvant sorafenib therapy. Increased GGT predicted a worse OS. NLR and GGT can be monitored dynamically before and after sorafenib therapy.

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Acknowledgments

This project was supported by a Grant from the National Natural Science Foundation of China (No. 81101871 & No.81372635), a Grant from the Tianjin Municipal Science and Technology Commission (TSTC, No.14JCYBJC25200), and a Grant from the Major Programs of the National Natural Science Foundation of Tianjin (No. 11JCZDJC18800). Grants were also received from the Program for a New Generation of Exceptional Personnel of Tianjin Medical University Cancer Hospital and the Tianjin Medical University Cancer Institute and Hospital of the National Clinical Research Center for Cancer.

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All authors declare that they do not have a commercial or other association that might pose a conflict of interest.

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Authors and Affiliations

  1. Department of Hepatobiliary Surgery, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, 24 Bin Shui Road, Hexi District, Tianjin, 300060, China

    Wei Zhang, Gang Zhao, Kai Wei, Qingxiang Zhang, Weiwei Ma, Qiang Wu, Ti Zhang, Dalu Kong, Qiang Li & Tianqiang Song

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  1. Wei Zhang
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  2. Gang Zhao
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Correspondence to Wei Zhang or Tianqiang Song.

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Zhang, W., Zhao, G., Wei, K. et al. Adjuvant sorafenib therapy in patients with resected hepatocellular carcinoma: evaluation of predictive factors. Med Oncol 32, 107 (2015). https://doi.org/10.1007/s12032-015-0549-3

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