Surgery Today

, Volume 48, Issue 4, pp 431–438 | Cite as

Impact of surgical treatment after sorafenib therapy for advanced hepatocellular carcinoma

  • Hideaki Takeyama
  • Toru Beppu
  • Takaaki Higashi
  • Takayoshi Kaida
  • Kota Arima
  • Katsunobu Taki
  • Katsunori Imai
  • Hidetoshi Nitta
  • Hiromitsu Hayashi
  • Shigeki Nakagawa
  • Hirohisa Okabe
  • Daisuke Hashimoto
  • Akira Chikamoto
  • Takatoshi Ishiko
  • Motohiko Tanaka
  • Yutaka Sasaki
  • Hideo Baba
Original Article



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.


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).


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.


A long-term survival might be obtained for select HCC patients given adequate additional surgical treatment, even after sorafenib induction.


Hepatocellular carcinoma Sorafenib Surgical treatment 



Hepatocellular carcinoma


Median survival time


Response evaluation criteria in solid tumors


Performance status




Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein protein


Des-gamma-carboxyl prothrombin


Transarterial chemoembolization


Radiofrequency ablation


New liver cancer therapies


Portal vein tumor thrombosis



This manuscript has not been published and is not under consideration for publication elsewhere. All of the authors have read the manuscript and have approved this submission.

Compliance with ethical standards


This study received no financial support.

Conflict of interest

The authors report no conflicts of interest.


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Copyright information

© Springer Japan KK 2017

Authors and Affiliations

  • Hideaki Takeyama
    • 1
  • Toru Beppu
    • 1
  • Takaaki Higashi
    • 1
  • Takayoshi Kaida
    • 1
  • Kota Arima
    • 1
  • Katsunobu Taki
    • 1
  • Katsunori Imai
    • 1
  • Hidetoshi Nitta
    • 1
  • Hiromitsu Hayashi
    • 1
  • Shigeki Nakagawa
    • 1
  • Hirohisa Okabe
    • 1
  • Daisuke Hashimoto
    • 1
  • Akira Chikamoto
    • 1
  • Takatoshi Ishiko
    • 1
  • Motohiko Tanaka
    • 2
  • Yutaka Sasaki
    • 2
  • Hideo Baba
    • 1
  1. 1.Department of Gastroenterological SurgeryKumamoto University Graduate School of Life SciencesKumamotoJapan
  2. 2.Department of Gastroenterology and HepatologyKumamoto University Graduate School of Life SciencesKumamotoJapan

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