title: Sorafenib combined with transarterial chemoembolization for the treatment of advanced hepatocellular carcinoma: a large-scale multicenter study of 222 patients.
abstract: BACKGROUND
  Data on the efficacy and safety of sorafenib in combination with transarterial chemoembolization (TACE) in patients with advanced hepatocellular carcinoma (HCC) are lacking.
  
  
  METHODS
  In this multicenter retrospective study, 222 consecutive HCC patients receiving combination therapy were enrolled between June 2008 and July 2011.
  
  
  RESULTS
  Chronic hepatitis B was the predominant cause of HCC (86%). Eighty percent patients were at Barcelona Clinic Liver Cancer (BCLC) stage C, and 86% patients were in Child-Pugh (CP) A class. The overall median survival was 12 months (95% CI 10.1-13.9). The overall incidence of adverse events (AEs) was 87%. In 177 BCLC-C patients, performance status, the number of HCC nodules, Child-Pugh score and macrovascular invasion were significantly associated with overall survival (OS) and were included in the final risk scores (R), where R = 5 × (vascular invasion: 0 if no, 1 yes) + 6 × (CP: 0 if A, 1 if B) + 7 × (no. of lesions: 0 if 1-2, 1 ≥3) + 8 × ( Eastern Cooperative Oncology Group, ECOG: 0 if 0, 1 ≥1).
  
  
  CONCLUSIONS
  Sorafenib in combination with TACE should be considered a safe and effective therapy for advanced HCC. Further validation of the new subgroup of BCLC-C stage is warranted in an independent patient cohort.
authors.affiliation: Department of Liver Disease and Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an.
authors.forename: Y
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Liver Disease and Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an.
authors.forename: W J
authors.initials: WJ
authors.lastname: Wang
authors.affiliation: Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou.
authors.forename: S
authors.initials: S
authors.lastname: Guan
authors.affiliation: Department of Radiology, Henan Tumor Hospital, Zhengzhou.
authors.forename: H L
authors.initials: HL
authors.lastname: Li
authors.affiliation: Department of Hepatobiliary and Pancreatic Medicine, Hunan Provincial Tumor Hospital, Changsha.
authors.forename: R C
authors.initials: RC
authors.lastname: Xu
authors.affiliation: Department of Oncology, the Second Affiliated Hospital of Nanchang University, Nanchang.
authors.forename: J B
authors.initials: JB
authors.lastname: Wu
authors.affiliation: Department of Minimally Invasive Medicine, Hunan Province People's Hospital, Changsha.
authors.forename: J S
authors.initials: JS
authors.lastname: Liu
authors.affiliation: Department of Interventional Radiology, Xiangya Hospital of Central-south University, Changsha.
authors.forename: H P
authors.initials: HP
authors.lastname: Li
authors.affiliation: Department of Liver Disease and Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an.
authors.forename: W
authors.initials: W
authors.lastname: Bai
authors.affiliation: Department of Liver Disease and Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an.
authors.forename: Z X
authors.initials: ZX
authors.lastname: Yin
authors.affiliation: Department of Liver Disease and Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an; State Key Laboratory of Cancer Biology and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
authors.forename: D M
authors.initials: DM
authors.lastname: Fan
authors.affiliation: Department of Liver Disease and Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an; Department of Radiology, Northwestern University, Chicago, USA.
authors.forename: Z L
authors.initials: ZL
authors.lastname: Zhang
authors.affiliation: Department of Liver Disease and Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an. Electronic address: guohhan@126.com.
authors.forename: G H
authors.initials: GH
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D003131:Combined Modality Therapy; D003967:Diarrhea / Q000139:chemically induced; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009536:Niacinamide / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D010671:Phenylurea Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D016016:Proportional Hazards Models; D012372:ROC Curve; D012189:Retrospective Studies; D000077157:Sorafenib; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib
keywords: hepatocellular carcinoma; sorafenib; transarterial chemoembolization