title: Prognostic factors in patients with advanced hepatocellular carcinoma treated with sorafenib.
abstract: BACKGROUND
  Sorafenib is the new reference standard for patients with advanced hepatocellular carcinoma (HCC).
  
  
  OBJECTIVE
  To identify prognostic factors in sorafenib-treated HCC patients and to evaluate outcomes with respect to liver function.
  
  
  METHODS
  In this retrospective study, 148 HCC patients received sorafenib 400 mg b.d. across 11 Austrian institutions. Seventy-eight HCC patients who received best supportive care (BSC) in the pre-sorafenib era served as a control.
  
  
  RESULTS
  In sorafenib-treated patients, low baseline α-fetoprotein, low Child-Pugh (CP) score, compensated cirrhosis, and low baseline aspartate aminotransferase (AST) were associated with significantly longer overall survival (OS) on univariate analysis. CP score and baseline AST remained independent prognostic factors on multivariate analysis. In patients with Barcelona Clinic liver Cancer (BCLC) stage B or C HCC (sorafenib: n = 139; BSC: n = 39), CP-A patients had a median OS of 11.3 (sorafenib [n = 76]) vs. 6.4 (BSC [n = 17]) months (P = 0.010), and CP-B patients had a median OS of 5.5 (sorafenib [n = 55]) vs. 1.9 (BSC [n = 22]) months (P = 0.021). In the sorafenib group, median OS according to baseline AST was 11.8 (<100 U/L [n = 58]) vs. 3.9 (≥100 U/L [n = 15]) months for CP-A patients (P = 0.127), and 6.5 (<100 U/L [n = 33]) vs. 2.1 (≥100 U/L [n = 21]) months for CP-B patients (P = 0.011). There was no survival difference between sorafenib and BSC in patients with BCLC stage D HCC (1.5 vs. 1.4 months; P = 0.116).
  
  
  CONCLUSIONS
  Sorafenib was associated with improved survival in both CP-A and CP-B patients. In CP-B patients, baseline AST may be helpful in determining which patients are most likely to benefit from sorafenib.
authors: Department of Gastroenterology and Hepatology, AKH & Medizinische Universität Wien, Austria.
authors: M
authors: M
authors: Pinter
authors: W
authors: W
authors: Sieghart
authors: F
authors: F
authors: Hucke
authors: I
authors: I
authors: Graziadei
authors: W
authors: W
authors: Vogel
authors: A
authors: A
authors: Maieron
authors: R
authors: R
authors: Königsberg
authors: A
authors: A
authors: Weissmann
authors: G
authors: G
authors: Kornek
authors: J
authors: J
authors: Matejka
authors: R
authors: R
authors: Stauber
authors: R
authors: R
authors: Buder
authors: B
authors: B
authors: Grünberger
authors: M
authors: M
authors: Schöniger-Hekele
authors: C
authors: C
authors: Müller
authors: M
authors: M
authors: Peck-Radosavljevic
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001557:Benzenesulfonates / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D011379:Prognosis; D011725:Pyridines / Q000627:therapeutic use*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D000077157:Sorafenib; D013223:Statistics as Topic; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D010671:Phenylurea Compounds; D011725:Pyridines; D009536:Niacinamide; D000077157:Sorafenib