title: Safety and efficacy of sorafenib for the treatment of recurrent hepatocellular carcinoma after liver transplantation.
abstract: BACKGROUND
  Recurrent hepatocellular carcinoma (HCC) following liver transplantation (LT) carries a poor prognosis. The aim of our study was to assess the safety and efficacy of sorafenib in patients with recurrent HCC following LT.
  
  
  METHODS
  A prospectively maintained LT database was retrospectively analyzed for patients with recurrent HCC following LT between 2001 and 2011-34 patients. Patients were divided into two groups based on whether they were prescribed sorafenib (n = 17) or not prescribed sorafenib (n = 17). The primary endpoint was overall survival.
  
  
  RESULTS
  There were no significant differences between the two groups analyzed. Seventeen patients were on sorafenib for recurrent HCC, with a mean daily dose of ~444 mg. Mean duration of treatment was ~10 months. Side effects included: thrombocytopenia, diarrhea, rising transaminases, fatigue, hand-foot skin reaction, and nausea. Survival in the sorafenib vs. non-sorafenib group was greater at three-, six-, nine-, and 12-month intervals and overall survival.
  
  
  CONCLUSIONS
  Sorafenib can be well tolerated and safe in patients with recurrent HCC following LT and may be associated with a modest survival benefit. To our knowledge, this is the largest single-center retrospective analysis of patients prescribed sorafenib for recurrent HCC after LT.
authors.affiliation: Hepatobiliary and Liver Transplant Surgery, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
authors.forename: Abhijeet
authors.initials: A
authors.lastname: Waghray
authors.forename: Bengi
authors.initials: B
authors.lastname: Balci
authors.forename: Galal
authors.initials: G
authors.lastname: El-Gazzaz
authors.forename: Richard
authors.initials: R
authors.lastname: Kim
authors.forename: Robert
authors.initials: R
authors.lastname: Pelley
authors.forename: K V
authors.initials: KV
authors.lastname: Narayanan Menon
authors.forename: Bassam
authors.initials: B
authors.lastname: Estfan
authors.forename: Carlos
authors.initials: C
authors.lastname: Romero-Marrero
authors.forename: Federico
authors.initials: F
authors.lastname: Aucejo
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology; D009536:Niacinamide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000627:therapeutic use*; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D000077157:Sorafenib
chemical_list: D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors; D009536:Niacinamide; D000077157:Sorafenib
keywords: MELD; Milan criteria; hepatocellular carcinoma; liver transplantation; sorafenib