title: Safety of liver resection for hepatocellular carcinoma after sorafenib therapy: a multicenter case-matched study.
abstract: BACKGROUND
  Liver resection can be considered in some hepatocellular carcinoma (HCC) patients who received sorafenib. The lack of clinical data about safety of resection after sorafenib treatment led us to assess its potential impact on perioperative course in a multicentric study.
  
  
  METHODS
  From 2008 to 2011, a total of 23 HCC patients who underwent liver resection after treatment with sorafenib (sorafenib group) were compared with 46 HCC patients (control group) matched for age, gender, underlying liver disease, tumor characteristics and type of resection. Patients received sorafenib for a median duration of 1 (range 0.2-11) months and drug was interrupted at least 7 days before surgery. End points were intraoperative (operative time, vascular clamping, blood loss and transfusion), and postoperative outcomes focusing on recovery of liver function.
  
  
  RESULTS
  In the sorafenib group, HCC was developed on F4 cirrhosis in 48 % and the rate of major resection was 44 %. Surgical procedure duration (280 vs. 240 min), transfusion rate (26 vs. 15 %), blood loss (400 vs. 300 mL) and vascular clamping (70 vs. 74 %) were similar in the two groups. Mortality was zero in the sorafenib group and one (2.1 %) in the control group (p = 1.000). The incidence of postoperative complications was 44 % in the sorafenib group and 59 % in the control group (p = 0.307). Recovery of liver function was similar in the two groups in terms of prothrombin time (90 vs. 81 %, p = 0.429) and bilirubin level (16 vs. 24 μmol/L, p = 102) at postoperative day 5.
  
  
  CONCLUSIONS
  No adverse effect of preoperative administration of sorafenib was observed during and immediately after liver resection for HCC.
authors.affiliation: Department of HPB Surgery, Beaujon Hospital, Clichy, France.
authors.forename: Louise
authors.initials: L
authors.lastname: Barbier
authors.forename: David
authors.initials: D
authors.lastname: Fuks
authors.forename: Patrick
authors.initials: P
authors.lastname: Pessaux
authors.forename: Fabrice
authors.initials: F
authors.lastname: Muscari
authors.forename: Yves-Patrice
authors.initials: YP
authors.lastname: Le Treut
authors.forename: Sandrine
authors.initials: S
authors.lastname: Faivre
authors.forename: Jacques
authors.initials: J
authors.lastname: Belghiti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001803:Blood Transfusion; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy / Q000401:mortality* / Q000601:surgery; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000401:mortality*; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009536:Niacinamide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000627:therapeutic use*; D011183:Postoperative Complications; D011379:Prognosis; D000077157:Sorafenib; D015996:Survival Rate; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib