Transarterial chemoembolization versus sorafenib in patients with hepatocellular carcinoma and extrahepatic disease

Martha M. Kirstein, Torsten Voigtländer, Nora Schweitzer, Jan B. Hinrichs, Jens Marquardt, Marcus Alexander Wörns, Roman Kloeckner, Thorben W. Fründt, Harald Ittrich, Frank Wacker, Thomas Rodt, Michael P. Manns, Henning Wege, Arndt Weinmann, Arndt Vogel*

*Corresponding author for this work
9 Citations (Scopus)

Abstract

Background: Sorafenib is the recommended treatment for advanced hepatocellular carcinoma (HCC), but transarterial chemoembolization (TACE) is performed in individual cases with limited extrahepatic spread. The aim of this study was to compare the outcome of patients with HCC and extrahepatic disease (EHD) treated with sorafenib and TACE. Methods: A total of 172 patients with HCC and EHD treated with sorafenib (n = 98) or TACE (n = 74) at three German referral centers (Hannover, Mainz and Hamburg) were included in this study. In order to reduce selection bias, patients were matched for significant demographic differences using a propensity score analysis. Results: Patients with liver cirrhosis, higher extrahepatic tumor burden and/or infiltration of adjacent organs/structures were significantly more often treated with sorafenib. Median overall survival (OS) was similar for sorafenib- and TACE-treated patients (7 versus 8 months, p = 0.312). In a propensity score analysis matched for demographic differences, median OS remained similar with 4 versus 8 months for sorafenib versus TACE (p = 0.613). Conclusion: Treatment with TACE is not inferior to treatment with sorafenib in patients with limited EHD of HCC. TACE represents an effective therapeutic option in selected patients with EHD.

Original languageEnglish
JournalUnited European Gastroenterology Journal
Volume6
Issue number2
Pages (from-to)238-246
Number of pages9
ISSN2050-6406
DOIs
Publication statusPublished - 01.03.2018

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