title: Clinical characteristics of advanced hepatocellular carcinoma patients with prolonged survival in the era of anti-angiogenic targeted-therapy.
abstract: BACKGROUND
  The prognosis of patients with advanced hepatocellular carcinoma (HCC) is poor despite treatment with sorafenib or other anti-angiogenic targeted-therapies. Patients with advanced HCC with prolonged survival may exhibit unique clinical characteristics.
  
  
  METHODS
  We reviewed patients with Barcelona Clinic Liver Cancer stage C HCC, who were enrolled in six clinical trials for first-line anti-angiogenic targeted-therapy between May 2005 and December 2010 in a single Institute. Patients with prolonged survival were identified as those who exhibited overall survival (OS) of more than two years; their clinical variables were analyzed.
  
  
  RESULTS
  Of the 189 enrolled patients, 22 (11.6%) patients with prolonged survival were identified. Their median OS was 58.7 (range=24.6-88.4) months, compared to an OS of 7.1 months for the overall patient cohort. A multivariate analysis showed that the patients with prolonged survival were less likely to have chronic hepatitis B virus infection, α-fetoprotein level >400 ng/ml, and liver involvement than were the remaining patients. In addition, the patients with prolonged survival experienced significantly higher response rates (50.0%) and disease control rates (86.4%) to the first-line targeted-therapy, and received more additional therapies than did the other patients. Seven patients remained disease-free for a median of 27.0 (range, 4.5-64.6) months after receiving additional locoregional therapies.
  
  
  CONCLUSIONS
  Patients with advanced HCC who experienced prolonged survival exhibited certain clinical features and strong treatment responses to first-line anti-angiogenic targeted-therapies. Additional locoregional therapies could contribute to the long-term disease-free status in selected patients.
authors: Department of Oncology, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 10002, Taiwan, R.O.C. chihhunghsu@ntu.edu.tw.
authors: Li-Chun
authors: LC
authors: Lu
authors: Yu-Yun
authors: YY
authors: Shao
authors: Soa-Yu
authors: SY
authors: Chan
authors: Chih-Hung
authors: CH
authors: Hsu
authors: Ann-Lii
authors: AL
authors: Cheng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000188:drug therapy*; D017326:Clinical Trials, Phase III as Topic; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000188:drug therapy; D016032:Randomized Controlled Trials as Topic; D055815:Young Adult
chemical_list: D020533:Angiogenesis Inhibitors
keywords: Clinical features; HCC; anti-angiogenic targeted therapy; hepatocellular carcinoma; long-term survivors; prognosis; prolonged survival; sorafenib