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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
  • 187 Downloads

Abstract

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.

Keywords

Hepatocellular carcinoma Sorafenib Surgical treatment 

Abbreviations

HCC

Hepatocellular carcinoma

MST

Median survival time

RECIST

Response evaluation criteria in solid tumors

PS

Performance status

AFP

Alpha-fetoprotein

AFP-L3

Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein protein

DCP

Des-gamma-carboxyl prothrombin

TACE

Transarterial chemoembolization

RFA

Radiofrequency ablation

NLCT

New liver cancer therapies

PVTT

Portal vein tumor thrombosis

Notes

Acknowledgements

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

Funding

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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