TY - JOUR
T1 - Transarterial chemoembolization versus sorafenib in patients with hepatocellular carcinoma and extrahepatic disease
AU - Kirstein, Martha M.
AU - Voigtländer, Torsten
AU - Schweitzer, Nora
AU - Hinrichs, Jan B.
AU - Marquardt, Jens
AU - Wörns, Marcus Alexander
AU - Kloeckner, Roman
AU - Fründt, Thorben W.
AU - Ittrich, Harald
AU - Wacker, Frank
AU - Rodt, Thomas
AU - Manns, Michael P.
AU - Wege, Henning
AU - Weinmann, Arndt
AU - Vogel, Arndt
N1 - Publisher Copyright:
© 2017, © Author(s) 2017.
PY - 2018/3/1
Y1 - 2018/3/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85042543305&partnerID=8YFLogxK
U2 - 10.1177/2050640617716597
DO - 10.1177/2050640617716597
M3 - Journal articles
AN - SCOPUS:85042543305
SN - 2050-6406
VL - 6
SP - 238
EP - 246
JO - United European Gastroenterology Journal
JF - United European Gastroenterology Journal
IS - 2
ER -