Evaluation of sorafenib treatment and hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma: a comparative study using the propensity score matching method

• Published in: Cancer medicine (Malden, MA) MA), 2015-08, Vol.4 (8), p.1214-1223
• Main Authors: Fukubayashi, Kotaro, Tanaka, Motohiko, Izumi, Kazuhiro, Watanabe, Takehisa, Fujie, Satomi, Kawasaki, Takeshi, Yoshimaru, Yoko, Tateyama, Masakuni, Setoyama, Hiroko, Naoe, Hideaki, Kikuchi, Ken, Sasaki, Yutaka
• Format: Article
• Language: English
• Subjects: Aged; Antineoplastic Agents - administration & dosage; Cancer therapies; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - pathology; Chemotherapy; Clinical Cancer Research; Disease Progression; Female; Growth factors; hepatic arterial infusion chemotherapy; Hepatic Artery; Hepatocellular carcinoma; Humans; Infusions, Intra-Arterial; Kaplan-Meier Estimate; Liver cancer; Liver Neoplasms - drug therapy; Liver Neoplasms - mortality; Liver Neoplasms - pathology; Male; Medical prognosis; Middle Aged; Niacinamide - administration & dosage; Niacinamide - analogs & derivatives; NMR; Nuclear magnetic resonance; Patients; Performance evaluation; Phenylurea Compounds - administration & dosage; Portal vein; Prognosis; Propensity Score; Protein Kinase Inhibitors - administration & dosage; Sorafenib; Studies; Survival; Treatment Outcome
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.476

While sorafenib (SFN) is the established worldwide standard therapeutic agent for advanced hepatocellular carcinoma (HCC), hepatic arterial infusion chemotherapy (HAIC) is also considered a favorable treatment for some advanced HCCs. This study aimed to evaluate each treatment and provide an optimal therapeutic choice for advanced HCCs. We analyzed 72 patients treated with SFN and 128 patients receiving HAIC. Both treatment groups were analyzed for prognostic and disease progression factors, and matched pair analysis was performed using the propensity score matching method. The preferable status of intrahepatic lesions, that is, no lesions or only a single (5 cm) and low albumin (≤3.4 g/dL) were poor prognostic and disease progression factors in the HAIC group. Analysis of 53 patients selected from each of the SFN and HAIC groups based on the propensity score matching method showed no significant differences in survival or disease progression between the two matched subgroups. On the other hand, progression‐free survival (PFS) in the HAIC‐matched subgroup was significantly longer than in the SFN‐matched subgroup, particularly in patients with portal vein invasion (PVI) and/or without extrahepatic spread (EHS). The treatment efficacy of HAIC is similar to that of SFN regarding survival and disease progression. Longer PFS might be expected for HAIC compared with SFN, particularly in patients with PVI and/or without EHS. Matched comparative cohort study of advanced hepatocellular carcinoma in the patients treated with sorafenib and hepatic arterial infusion chemotherapy (HAIC) suggested that the efficacy of HAIC is similar to sorafenib for survival and disease progression. In addition, HAIC might be advantageous for patients with portal vein invasion and/or without extrahepatic spread.