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

doi:10.1177/2050640617716597

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

Clinic of Internal Medicine I

20 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 language	English
Journal	United European Gastroenterology Journal
Volume	6
Issue number	2
Pages (from-to)	238-246
Number of pages	9
ISSN	2050-6406
DOIs	https://doi.org/10.1177/2050640617716597
Publication status	Published - 01.03.2018

Funding

Martha M. Kirstein was supported by the Ellen Schmidt program from Hannover Medical School, Germany.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Access to Document

10.1177/2050640617716597

Cite this

Kirstein, M. M., Voigtländer, T., Schweitzer, N., Hinrichs, J. B., Marquardt, J., Wörns, M. A., Kloeckner, R., Fründt, T. W., Ittrich, H., Wacker, F., Rodt, T., Manns, M. P., Wege, H., Weinmann, A., & Vogel, A. (2018). Transarterial chemoembolization versus sorafenib in patients with hepatocellular carcinoma and extrahepatic disease. United European Gastroenterology Journal, 6(2), 238-246. https://doi.org/10.1177/2050640617716597

@article{20d3a157cb154417bb5948f4a007e2e3,

title = "Transarterial chemoembolization versus sorafenib in patients with hepatocellular carcinoma and extrahepatic disease",

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.",

author = "Kirstein, \{Martha M.\} and Torsten Voigtl{\"a}nder and Nora Schweitzer and Hinrichs, \{Jan B.\} and Jens Marquardt and W{\"o}rns, \{Marcus Alexander\} and Roman Kloeckner and Fr{\"u}ndt, \{Thorben W.\} and Harald Ittrich and Frank Wacker and Thomas Rodt and Manns, \{Michael P.\} and Henning Wege and Arndt Weinmann and Arndt Vogel",

note = "Publisher Copyright: {\textcopyright} 2017, {\textcopyright} Author(s) 2017.",

year = "2018",

month = mar,

day = "1",

doi = "10.1177/2050640617716597",

language = "English",

volume = "6",

pages = "238--246",

journal = "United European Gastroenterology Journal",

issn = "2050-6406",

publisher = "John Wiley \& Sons Inc.",

number = "2",

}

Kirstein, MM, Voigtländer, T, Schweitzer, N, Hinrichs, JB, Marquardt, J, Wörns, MA, Kloeckner, R, Fründt, TW, Ittrich, H, Wacker, F, Rodt, T, Manns, MP, Wege, H, Weinmann, A & Vogel, A 2018, 'Transarterial chemoembolization versus sorafenib in patients with hepatocellular carcinoma and extrahepatic disease', United European Gastroenterology Journal, vol. 6, no. 2, pp. 238-246. https://doi.org/10.1177/2050640617716597

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

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 - https://www.scopus.com/pages/publications/85042543305

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 -

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

Abstract

Funding

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this