title: Hepatocellular carcinoma: concomitant sorafenib promotes necrosis after radiofrequency ablation--propensity score matching analysis.
abstract: OBJECTIVE
  To retrospectively compare radiofrequency ablation (RFA) combined with the multikinase inhibitor sorafenib (hereafter, sorafenib-RFA) and RFA alone in the treatment of hepatocellular carcinoma (HCC).
  
  
  METHODS
  Institutional review board approval and informed consent were obtained. Between January 2007 and December 2011, 16 patients (mean age, 72.8 years; age range 52-84 years; 10 men, six women) with HCC tumors less than 3 cm in diameter were included in the sorafenib-RFA group, and 136 patients (mean age, 72.1 years; age range, 51-86 years; 92 men, 44 women) with HCC tumors less than 3 cm in diameter were included in the RFA alone (control) group. Mean diameters of the greatest long-axis dimensions of HCC were 22.8 mm ± 4.6 (standard deviation) in the sorafenib-RFA group and 18.1 mm ± 4.4 in the control group. RFA was performed immediately after the 7-day administration of sorafenib. Propensity score matching analysis was used to adjust for potential biases.
  
  
  RESULTS
  Fifteen of the 16 patients in the sorafenib-RFA group and 30 of the 136 patients in the control group were selected during propensity score matching. No significant differences between the sorafenib-RFA group (n = 15) and the control group (n = 30) were observed with regard to age, sex, etiology, Child-Pugh class, tumor size, puncture number, needle size, location at the liver margin, or location adjacent to a main vessel. The respective mean diameters of the greatest long- and short-axis dimensions of the RFA-induced ablated area were 46.3 mm ± 10.3 and 33.0 mm ± 6.9 in the sorafenib-RFA group and 32.9 mm ± 7.6 and 25.6 mm ± 5.7 in the control group; both of these dimensions were significantly larger in the sorafenib-RFA group (both P < .001).
  
  
  CONCLUSIONS
  Sorafenib-RFA may be superior to standard RFA alone in the treatment of HCC tumors smaller than 3 cm in diameter.
authors.affiliation: From the Gastroenterological Center (H.F., K.N., S. Moriya, Y.S., T.I., A.N., M.K., M.M., K.T.), Department of Gastroenterology (S. Maeda), Department of Biostatistics and Epidemiology (K.S., S. Morita), and Clinical Research Coordinating Center (K.S., S. Morita, K.T.), Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa 232-0024, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Fukuda
authors.forename: Kazushi
authors.initials: K
authors.lastname: Numata
authors.forename: Satoshi
authors.initials: S
authors.lastname: Moriya
authors.forename: Yu
authors.initials: Y
authors.lastname: Shimoyama
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Ishii
authors.forename: Akito
authors.initials: A
authors.lastname: Nozaki
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kondo
authors.forename: Manabu
authors.initials: M
authors.lastname: Morimoto
authors.forename: Shin
authors.initials: S
authors.lastname: Maeda
authors.forename: Kentaro
authors.initials: K
authors.lastname: Sakamaki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Morita
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods; D003287:Contrast Media; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009536:Niacinamide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000627:therapeutic use*; D057216:Propensity Score; D012189:Retrospective Studies; D000077157:Sorafenib; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib