title: Safety and efficacy of transarterial chemoembolization plus sorafenib for hepatocellular carcinoma with portal venous tumour thrombus.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of combined therapy with transarterial chemoembolization (TACE) and sorafenib for hepatocellular carcinoma (HCC) with portal venous tumour thrombus (PVTT).
  
  
  METHODS
  This study was approved by the institutional review board. From May 2009 to May 2012, 170 consecutive patients were newly diagnosed with advanced-stage HCC and treated with TACE plus sorafenib. Among them, 41 patients with PVTT were retrospectively enrolled in the study. The adverse events (AEs), overall survival (OS), time to progression (TTP), and prognostic factors were analysed. Statistical analysis was performed with the Kaplan-Meier method using the log-rank test and Cox regression models.
  
  
  RESULTS
  The most common AEs were hand-foot skin reaction related to sorafenib and fever related to TACE. Procedure-related mortality and grade 4 AEs were not observed. Grade 3 AEs were observed in five patients. During the median follow-up period of 13.5 months (range 1.4-45 months), the 6-month and 1-year survival rates were 87.7% and 53.6%, respectively. The median OS was 13 months (range 1.4-44.8 months), and the median TTP was 7 months (range 1-18.6 months). The Child-Pugh class (p = 0.022), extrahepatic metastasis (p = 0.009), and gross morphological type (nodular type versus diffuse type; p = 0.008) were prognostic factors related to OS in the multivariate analysis.
  
  
  CONCLUSIONS
  TACE plus sorafenib in an interrupted therapeutic scheme was well tolerated and might improve OS for HCC patients with PVTT, especially in those with Child-Pugh class A, no extrahepatic metastasis, or nodular-type HCC.
authors.affiliation: Minimally Invasive Interventional Division, Medical Imaging Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, PR China.
authors.forename: T
authors.initials: T
authors.lastname: Pan
authors.affiliation: Department of Interventional Radiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, PR China.
authors.forename: X-S
authors.initials: XS
authors.lastname: Li
authors.affiliation: Minimally Invasive Interventional Division, Medical Imaging Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, PR China.
authors.forename: Q-K
authors.initials: QK
authors.lastname: Xie
authors.affiliation: Minimally Invasive Interventional and Target Treatment Division and Cancer Center, The First People's Hospital of Foshan City, The Affiliated Foshan Hospital of Sun Yat-sen University, Guangzhou, PR China.
authors.forename: J-P
authors.initials: JP
authors.lastname: Wang
authors.affiliation: Minimally Invasive Interventional Division, Medical Imaging Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, PR China.
authors.forename: W
authors.initials: W
authors.lastname: Li
authors.affiliation: Minimally Invasive Interventional Division, Medical Imaging Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, PR China.
authors.forename: P-H
authors.initials: PH
authors.lastname: Wu
authors.affiliation: Minimally Invasive Interventional Division, Medical Imaging Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, PR China. Electronic address: zhaoming@sysucc.org.cn.
authors.forename: M
authors.initials: M
authors.lastname: Zhao
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods; D003872:Dermatitis / Q000209:etiology; D003967:Diarrhea / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D005260:Female; D005334:Fever / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; 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*; D012189:Retrospective Studies; D000077157:Sorafenib; D016019:Survival Analysis; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000150:complications / Q000188:drug therapy / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib