title: The impact of patient and tumour baseline characteristics on the overall survival of patients with advanced hepatocellular carcinoma treated with sorafenib.
abstract: BACKGROUND
  Impact of patient and tumour baseline characteristics on the overall survival is not well characterized in patients with advanced hepatocellular carcinoma (HCC) treated with sorafenib.
  
  
  OBJECTIVE
  Univariate/multivariate analyses were conducted to identify retrospectively the impact of baseline characteristics on the survival of 110 patients with advanced HCC treated with sorafenib.
  
  
  RESULTS
  Median survival of the whole cohort was 6.7 months, median survival in Child-Pugh A, B, C patients was 10.5, 6.1 and 3.0 months and median survival of patients with Barcelona Clinic Liver Cancer (BCLC) stage C/D was 6.8/2.6 months. Presence of ascites, presence of macrovascular invasion and BCLC stage D (mainly determined by Child-Pugh C status and Eastern Cooperative Oncology Group Performance Status>2) remained independent prognostic factors for the survival on multivariate analysis. Particularly, the presence of macrovascular invasion significantly influenced survival both in patients with liver cirrhosis Child-Pugh A and Child-Pugh B.
  
  
  CONCLUSIONS
  Well maintained liver function and performance status are prerequisites for sorafenib treatment in patients with advanced HCC. Our findings do not support routine clinical use of sorafenib in Child-Pugh B patients. Evaluation of ascites and particularly macrovascular invasion might help to identify patients more likely to benefit from sorafenib treatment.
authors.affiliation: Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg University, Mainz, Germany. woerns@uni-mainz.de
authors.forename: Marcus A
authors.initials: MA
authors.lastname: Wörns
authors.forename: Sandra
authors.initials: S
authors.lastname: Koch
authors.forename: Ina M
authors.initials: IM
authors.lastname: Niederle
authors.forename: Jens U
authors.initials: JU
authors.lastname: Marquardt
authors.forename: Marc
authors.initials: M
authors.lastname: Nguyen-Tat
authors.forename: Thomas
authors.initials: T
authors.lastname: Gamstätter
authors.forename: Marcus
authors.initials: M
authors.lastname: Schuchmann
authors.forename: Henning
authors.initials: H
authors.lastname: Schulze-Bergkamen
authors.forename: Peter R
authors.initials: PR
authors.lastname: Galle
authors.forename: Arndt
authors.initials: A
authors.lastname: Weinmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009536:Niacinamide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000627:therapeutic use*; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D000077157:Sorafenib; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib