title: Practical effect of sorafenib monotherapy on advanced hepatocellular carcinoma and portal vein tumor thrombosis.
abstract: OBJECTIVE
  We investigated the effects of sorafenib monotherapy on advanced hepatocellular carcinoma (HCC) and portal vein tumor thrombosis (PVTT) in a clinical setting.
  
  
  METHODS
  In total, 143 consecutive patients with unresectable HCC were treated with sorafenib. Among these patients, 30 patients with advanced HCC and PVTT (Vp3 or 4) were treated with sorafenib monotherapy.
  
  
  RESULTS
  All patients had a performance status of 1 to 2 (Eastern Cooperative Oncology Group 1/2, 20/10) and Child-Pugh class A or B (A/B, 17/13). Eleven patients had modified Union for International Cancer Control stage IVA tumors, whereas 19 had stage IVB tumors. All patients had PVTT (Vp3, 6; Vp4, 24). Following sorafenib monotherapy, three patients (10.0%) had a partial response with PVTT revascularization, and nine (30.0%) had stable disease, with a disease control rate of 33.3%. The median overall survival was 3.1 months (95% confidence interval [CI], 2.70 to 3.50), and the median progression-free survival was 2.0 months (95% CI, 1.96 to 2.05). Fatigue and hand-foot skin reactions were the most troublesome side effects.
  
  
  CONCLUSIONS
  A limited proportion of patients with advanced HCC and PVTT exhibited a remarkable outcome after sorafenib monotherapy, although the treatment results in this type of patient is extremely poor. Further studies to predict good responders to personalized therapy are warranted.
authors: Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
authors: Soung Won
authors: SW
authors: Jeong
authors: Jae Young
authors: JY
authors: Jang
authors: Kwang Yeun
authors: KY
authors: Shim
authors: Sae Hwan
authors: SH
authors: Lee
authors: Sang Gyune
authors: SG
authors: Kim
authors: Sang-Woo
authors: SW
authors: Cha
authors: Young Seok
authors: YS
authors: Kim
authors: Young Deok
authors: YD
authors: Cho
authors: Hong Soo
authors: HS
authors: Kim
authors: Boo Sung
authors: BS
authors: Kim
authors: Kyoung Ha
authors: KH
authors: Kim
authors: Jung Hoon
authors: JH
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000855:Anorexia / Q000139:chemically induced; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology; D003967:Diarrhea / Q000139:chemically induced; D018572:Disease-Free Survival; D005221:Fatigue / Q000139:chemically induced; D005260:Female; D060831:Hand-Foot Syndrome / Q000209:etiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D009361:Neoplasm Invasiveness; D009536:Niacinamide / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D011169:Portal Vein / Q000473:pathology*; D016016:Proportional Hazards Models; D000077157:Sorafenib; D036542:Tomography, Spiral Computed; D020246:Venous Thrombosis / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib
keywords: Carcinoma, hepatocellular; Portal vein; Sorafenib; Thrombosis