Cancer Chemotherapy and Pharmacology

, Volume 82, Issue 3, pp 469–478 | Cite as

Randomized, prospective, comparative study on the effects and safety of sorafenib vs. hepatic arterial infusion chemotherapy in patients with advanced hepatocellular carcinoma with portal vein tumor thrombosis

  • Jong Hwan Choi
  • Woo Jin ChungEmail author
  • Si Hyun BaeEmail author
  • Do Seon Song
  • Myeong Jun Song
  • Young Seok Kim
  • Hyung Joon Yim
  • Young Kul Jung
  • Sang Jun Suh
  • Jun Yong Park
  • Do Young Kim
  • Seung Up Kim
  • Sung Bum Cho
Original Article



Treatment responses of advanced hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) remain unacceptably low and treatment modalities are limited. We compared the efficacy and safety of sorafenib and hepatic arterial infusion chemotherapy (HAIC).


In this randomized, prospective, comparative study, data on 58 patients with advanced HCC with PVTT, with Child–Turcotte–Pugh (CTP) scores of 5–7, were collected from six university hospitals between January 2013 and October 2015. Twenty-nine patients were treated with sorafenib and twenty-nine with HAIC.


The median overall survival (OS) and time to progression (TTP) were significantly longer in the HAIC group than in the sorafenib group (14.9 vs.7.2 months, p = 0.012 and 4.4 vs. 2.7 months, p = 0.010). The objective response (OR) rates were 27.6 and 3.4% in the HAIC and sorafenib groups, respectively (p = 0.001). In univariate analysis, sex, main portal vein invasion and treatment modality were significant prognostic factors of OS (p = 0.044, 0.040, 0.015), whereas cause of HCC, tumor number, tumor location and treatment modality were significant prognostic factors of TTP (p = 0.040, 0.002, 0.034, 0.014). In multivariate analysis, sex and treatment modality were significant prognostic factors of OS (p = 0.008, 0.005), whereas cause of HCC, tumor number, tumor location and treatment modality were significant prognostic factors of TTP (p = 0.038, 0.038, 0.015, 0.011). Major complications included hyperbilirubinemia (44.8%), AST elevation (34.5%), ascites (13.8%) and catheter-related complications (3.4%) in the HAIC group and hyperbilirubinemia (34.5%), hand-foot syndrome (31.0%) and AST elevation (27.6%) in the sorafenib group.


For managing advanced HCC with PVTT, HAIC may be a valuable treatment modality.


Hepatocellular carcinoma Portal vein tumor thrombosis Sorafenib Hepatic arterial infusion chemotherapy Prognosis 



Hepatocellular carcinoma


Portal vein tumor thrombosis


Hepatic arterial infusion chemotherapy




Hepatitis B virus


Hepatitis C virus


Modified Union for International Cancer Control




Eastern Cooperative Oncology Group


Absolute neutrophil count


Overall survival


Time to progression


Objective response


Barcelona Clinic Liver Cancer


European Association for the Study of Liver


Computed tomography


Magnetic resonance imaging


Modified Response Evaluation Criteria in Solid Tumors


Aspartate transaminase


Alanine aminotransferase


Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to declare.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Jong Hwan Choi
    • 1
  • Woo Jin Chung
    • 1
    Email author
  • Si Hyun Bae
    • 2
    Email author
  • Do Seon Song
    • 2
  • Myeong Jun Song
    • 2
  • Young Seok Kim
    • 3
  • Hyung Joon Yim
    • 4
  • Young Kul Jung
    • 4
  • Sang Jun Suh
    • 4
  • Jun Yong Park
    • 5
  • Do Young Kim
    • 5
  • Seung Up Kim
    • 5
  • Sung Bum Cho
    • 6
  1. 1.Department of Internal MedicineKeimyung University School of MedicineDaeguRepublic of Korea
  2. 2.Department of Internal Medicine, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
  3. 3.Department of Internal MedicineSoonchunhyang University Bucheon HospitalBucheonRepublic of Korea
  4. 4.Department of Internal MedicineKorea University Ansan HospitalAnsanRepublic of Korea
  5. 5.Department of Internal MedicineYonsei University College of MedicineSeoulRepublic of Korea
  6. 6.Department of Internal MedicineChonnam National University Medical SchoolGwangjuRepublic of Korea

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