Predictive factors of outcome and tumor response to systemic chemotherapy in patients with metastatic hepatocellular carcinoma.
OBJECTIVE
Systemic chemotherapy is an important treatment modality for metastatic hepatocellular carcinoma (HCC); however, the predictive factors of outcome and tumor response have not been fully investigated. The aim of this study was to identify factors that could be used to predict outcome and tumor response to systemic chemotherapy in patients with metastatic HCC.


METHODS
We retrospectively examined 82 consecutive patients with metastatic HCC undergoing systemic chemotherapy to investigate factors associated with outcome and tumor response. The patients underwent 5-fluorouracil, mitoxantrone and cisplatin (FMP) therapy.


RESULTS
The overall objective response rate was 22% (95% confidence interval, 14-32), and the median survival time and 1-year survival for all patients were 11.2 months and 43.5%, respectively. Multivariate analysis demonstrated that the absence of radiologically active intrahepatic disease (P = 0.02) and ascites (P = 0.002) was independent favorable prognostic factors. Although multivariate analysis revealed no significant predictive factors of tumor response, the response rates in patients without radiologically active intrahepatic disease (response rate, 46%) tended to be higher than those in patients with active intrahepatic disease (response rate, 17%) (P = 0.05).


CONCLUSIONS
Patients with metastatic HCC, who had sufficient hepatic function and no radiologically active intrahepatic disease, might be good candidates for systemic chemotherapy.
Ikeda
Masafumi
M
Division of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan. masikeda@east.ncc.go.jp
Okusaka
Takuji
T
Ueno
Hideki
H
Morizane
Chigusa
C
Kojima
Yasushi
Y
Iwasa
Satoru
S
Hagihara
Atsushi
A
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000556:secondary; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage; D009367:Neoplasm Staging; D011379:Prognosis; D012074:Remission Induction; D015996:Survival Rate; D016896:Treatment Outcome
D008942:Mitoxantrone; D002945:Cisplatin; D005472:Fluorouracil