title: A single center experience of sorafenib in advanced hepatocellular carcinoma patients:  evaluation of prognostic factors.
abstract: OBJECTIVE
  Sorafenib is the only effective drug for advanced hepatocellular carcinoma (HCC), but few data predictive of its effectiveness are available. To address this issue we analyzed the relationship between risk factors associated with sorafenib treatment and overall survival (OS).
  
  
  METHODS
  Forty patients with advanced HCC were treated with sorafenib. OS was the primary endpoint and tumor response was evaluated using the Response Evaluation Criteria in Solid Tumors. Demographics, and the efficacy and adverse effects of sorafenib were analyzed. Univariate and multivariate analysis were carried out to identify risk factors for OS. The side-effects of sorafenib were summarized, and published data related to sorafenib in patients with HCC were reviewed.
  
  
  RESULTS
  The median OS was 12.7 months. A partial response was achieved in five patients and stable disease was achieved in 24 patients, with a disease-stabilization rate of 60%. Hand-foot syndrome, hypertension, diarrhea, and fatigue were common adverse effects. Univariate analysis showed that tumor/lymph node/metastasis staging, Barcelona Clinic Liver Cancer staging, distant metastasis, ascites, and portal thrombosis were risk factors for OS. Multivariate analysis demonstrated that the presence of distant metastasis and ascites predicted poorer OS, and the presence of adverse effects predicted better OS. Presence of adverse effects can be used for monitoring the efficacy of sorafenib that has not been reported in previous studies.
  
  
  CONCLUSIONS
  Sorafenib demonstrated good efficacy and acceptable tolerability in treating an advanced HCC patient population, with or without prior treatment. The presence of ascites or distant metastasis predicted poorer OS, and the presence of adverse effects predicted improved OS.
authors.affiliation: Department of Hepatobiliary Surgery, Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, People's Republic of China. tjchi@hotmail.com
authors.forename: Tianqiang
authors.initials: T
authors.lastname: Song
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wu
authors.forename: Dalu
authors.initials: D
authors.lastname: Kong
authors.forename: Weiwei
authors.initials: W
authors.lastname: Ma
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001557:Benzenesulfonates / Q000009:adverse effects / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology / Q000556:secondary; D017322:Clinical Trials, Phase II as Topic; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D011379:Prognosis; D011725:Pyridines / Q000009:adverse effects / Q000627:therapeutic use*; D000077157:Sorafenib; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D010671:Phenylurea Compounds; D011725:Pyridines; D009536:Niacinamide; D000077157:Sorafenib