title: Advanced-stage hepatocellular carcinoma: transarterial chemoembolization versus sorafenib.
abstract: OBJECTIVE
  To compare the efficacies of transarterial chemoembolization (TACE) and sorafenib in patients with advanced-stage hepatocellular carcinoma (HCC).
  
  
  METHODS
  The retrospective analysis of the data was approved by the institutional review board; the requirement to obtain informed consent was waived. Three hundred seventy-two patients with HCC were treated between January 1999 and December 2009. Patients with advanced HCC according to the Barcelona Clinic Liver Cancer (BCLC) staging classification (Child-Pugh class A or B, Eastern Cooperative Oncology Group performance status of 1-2, and/or macrovascular invasion or extrahepatic metastasis) were included in the study (n = 97). Thirty-four patients underwent conventional TACE with doxorubicin plus lipiodol or TACE with drug-eluting beads; 63 patients were treated with sorafenib.
  
  
  RESULTS
  The median duration of sorafenib treatment was 4.6 months (95% confidence interval [CI]: 3.2, 6.0 months). The median number of TACE sessions per patient was 3 ± 2. Side effects of TACE and sorafenib were comparable to those reported in the literature. The median time to progression was similar between the two treatment groups (P = .737). The median overall survival was 9.2 months (95% CI: 6.1, 12.3 months) for patients treated with TACE and 7.4 months (95% CI: 5.6, 9.2 months) for those treated with sorafenib (P = .377). Only Child-Pugh class was associated with a better overall survival at uni- and multivariate analysis.
  
  
  CONCLUSIONS
  TACE achieved a promising outcome in select patients with advanced HCC (BCLC stage C).
authors.affiliation: Department of Gastroenterology and Hepatology, Medizinische Universität Wien, Vienna, Austria.
authors.forename: Matthias
authors.initials: M
authors.lastname: Pinter
authors.forename: Florian
authors.initials: F
authors.lastname: Hucke
authors.forename: Ivo
authors.initials: I
authors.lastname: Graziadei
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Vogel
authors.forename: Andreas
authors.initials: A
authors.lastname: Maieron
authors.forename: Robert
authors.initials: R
authors.lastname: Königsberg
authors.forename: Rudolf
authors.initials: R
authors.lastname: Stauber
authors.forename: Birgit
authors.initials: B
authors.lastname: Grünberger
authors.forename: Christian
authors.initials: C
authors.lastname: Müller
authors.forename: Claus
authors.initials: C
authors.lastname: Kölblinger
authors.forename: Markus
authors.initials: M
authors.lastname: Peck-Radosavljevic
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Sieghart
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001557:Benzenesulfonates / Q000008:administration & dosage* / Q000009:adverse effects; D014408:Biomarkers, Tumor / Q000032:analysis; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D016009:Chi-Square Distribution; D003287:Contrast Media / Q000008:administration & dosage; D018450:Disease Progression; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D004998:Ethiodized Oil / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D016016:Proportional Hazards Models; D011725:Pyridines / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D000077157:Sorafenib; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D014408:Biomarkers, Tumor; D003287:Contrast Media; D010671:Phenylurea Compounds; D011725:Pyridines; D009536:Niacinamide; D004998:Ethiodized Oil; D004317:Doxorubicin; D000077157:Sorafenib