title: Clinical outcome and prognostic factors of patients with hepatocellular carcinoma and extrahepatic metastasis treated with sorafenib.
abstract: OBJECTIVE
  The purpose of this study was to assess the clinical outcome and identify prognostic factors following treatment of patients with advanced hepatocellular carcinoma (HCC) and extrahepatic metastasis with sorafenib.
  
  
  METHODS
  Sixty-one HCC patients with extrahepatic metastasis who were treated with sorafenib were enrolled in this retrospective cohort study.
  
  
  RESULTS
  The median survival time (MST) of all patients was 11 months. The median time to radiological progression was 4.2 months. The response rates (complete response [CR] + partial response [PR]) by Response Evaluation Criteria in Solid Tumors (RECIST) and modified RECIST were 3.0% and 8.0%, respectively, while the disease control rates (CR + PR + stable disease) were 49% and 49%, respectively. Multivariate analysis identified T factor (intrahepatic tumor stage, T 0-2), response to disease control and des-γ-carboxy prothrombin (<2600 mAU/mL) as significant and independent determinants of survival. Intrahepatic tumor stage before treatment allows stratification of prognosis of patients treated with sorafenib. Four T0 patients remained alive. The MST of patients with T1 (n = 6), T2 (n = 10), T3 (n = 23) and T4 (n = 18) of intrahepatic tumor stage was 20, 23, 7 and 5 months, respectively. Among the progressive disease group, patients with T0-2 intrahepatic tumor stage had better prognosis than patients with T3-4.
  
  
  CONCLUSIONS
  In HCC patients with extrahepatic metastasis who are treated with sorafenib, intrahepatic tumor stage was a significant and independent prognostic factor.
authors: Department of Medicine and Molecular Science, Division of Frontier Medical Science, Hiroshima University, Hiroshima, Japan.
authors: Tomokazu
authors: T
authors: Kawaoka
authors: Hiroshi
authors: H
authors: Aikata
authors: Hiromi
authors: H
authors: Kan
authors: Hatsue
authors: H
authors: Fujino
authors: Takayuki
authors: T
authors: Fukuhara
authors: Tomoki
authors: T
authors: Kobayashi
authors: Noriaki
authors: N
authors: Naeshiro
authors: Daisuke
authors: D
authors: Miyaki
authors: Akira
authors: A
authors: Hiramatsu
authors: Michio
authors: M
authors: Imamura
authors: Yoshiiku
authors: Y
authors: Kawakami
authors: Hideyuki
authors: H
authors: Hyogo
authors: Kazuaki
authors: K
authors: Chayama
keywords: extrahepatic metastasis; hepatocellular carcinoma; intrahepatic tumor stage; sorafenib