title: Analysis of survival factors in patients with intermediate-advanced hepatocellular carcinoma treated with transcatheter arterial chemoembolization combined with sorafenib.
abstract: OBJECTIVE
  To retrospectively analyze the efficacy and safety of transcatheter arterial chemoembolization (TACE) in combination with sorafenib for the treatment of patients with intermediate-advanced hepatocellular carcinoma (HCC) and assess the prognostic impact of baseline characteristics.
  
  
  METHODS
  Patients with intermediate-advanced HCC received TACE combined with sorafenib in this Phase 2 clinical trial. The primary outcome was median time to disease progression (mTTP). Secondary outcomes were median overall survival (mOS), the disease benefit rate and the sorafenib-related adverse events (AEs). Baseline characteristics' impacts on prognosis were analyzed by univariate COX proportional hazards regression model.
  
  
  RESULTS
  From June 2008 to June 2013, 75 patients were enrolled. At the end of the study, 54 patients were dead or lost to follow-up and 21 patients survived. This combination therapy resulted in a mTTP of 7.09 months (95 % CI, 1.5-45 months) and a mOS of 11.44 months (95 % CI, 1.5-45 months). The disease benefit rate was 88 %. Child-Pugh score (P = 0.000), Eastern Cooperative Oncology Group performance status (P = 0.001), Barcelona Clinic Liver Cancer stage (P = 0.000), sorafenib treatment regimen (P = 0.001), presence of extrahepatic metastasis (P = 0.002), and type of tumor (P = 0.027) were significantly correlated with OS. Multivariate analysis revealed Child-Pugh score (P = 0.001) and BCLC stage (P = 0.002) as significant independent prognostic predictors for OS. AEs were HFSR (18.7 %), gastrointestinal reactions (13.3 %), liver dysfunction (6.7 %), myelosuppression (5.3 %), fatigue (4 %), and hypertension (1.3 %).
  
  
  CONCLUSIONS
  TACE in combination with sorafenib might have acceptable safety and efficiency in the treatment of intermediate-advanced HCC.
authors.affiliation: Department of Interventional Radiology, Zhejiang Cancer Hospital, No. 38 Guangji Road, Banshanqiao, Hangzhou, 310022, China, zhengjp_2013@126.com.
authors.forename: J
authors.initials: J
authors.lastname: Zheng
authors.forename: G
authors.initials: G
authors.lastname: Shao
authors.forename: J
authors.initials: J
authors.lastname: Luo
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000008:administration & dosage / Q000031:analogs & derivatives*; D010671:Phenylurea Compounds / Q000008:administration & dosage*; D016016:Proportional Hazards Models; D000077157:Sorafenib
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib