title: Feasibility and safety of sorafenib treatment in hepatocellular carcinoma patients with spontaneous rupture.
abstract: OBJECTIVE
  To report the outcome of patients with ruptured hepatocellular carcinoma (HCC) treated at a single center during a 5-year period.
  
  
  METHODS
  We retrospectively analyzed 32 patients who presented with ruptured HCC at Shandong Provincial Hospital Affiliated to Shandong University between 2008 and 2013.
  
  
  RESULTS
  The mean age of the patients was 53 years (range 39-71 years). Of these patients, 22 received surgical management, 10 underwent transarterial embolization (TAE) or transarterial chemoembolization (TACE), and 12 received sorafenib after surgery, TAE or TACE. Cumulative survival rates at 4, 8 and 12 mo were 72.9%, 50.0% and 33.3%, respectively, in the surgery only group and were 90.0%, 80.6% and 64.1%, respectively, in the surgery plus sorafenib group. Cumulative survival rates at 4, 8 and 12 mo were 68.4%, 43.6% and 19.4%, respectively, in the surgery only or TAE/TACE only groups, and were 91.7%, 75.0% and 60.2%, respectively, in the sorafenib combination groups (P = 0.04). No unexpected side effects due to sorafenib were observed. The most common side effect was hand-foot skin reaction. To date, 5 patients have died. Median follow-up from the start of sorafenib therapy for the remaining 7 patients is 12.7 mo (range 5.8-32.2 mo).
  
  
  CONCLUSIONS
  Sorafenib can be used in patients with ruptured HCC as it has interesting activity and is well tolerated; dose adjustment is generally not required. However, a larger prospective study is necessary to determine the efficacy of sorafenib in this group of patients.
authors.affiliation: Shun-Zhen Zheng, Guang-Sheng Yu, Yan-Tian Xu, Wei Gong, Jun Liu, Department of Liver Transplantation and Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China.
authors.forename: Shun-Zhen
authors.initials: SZ
authors.lastname: Zheng
authors.affiliation: Shun-Zhen Zheng, Guang-Sheng Yu, Yan-Tian Xu, Wei Gong, Jun Liu, Department of Liver Transplantation and Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China.
authors.forename: De-Jie
authors.initials: DJ
authors.lastname: Liu
authors.affiliation: Shun-Zhen Zheng, Guang-Sheng Yu, Yan-Tian Xu, Wei Gong, Jun Liu, Department of Liver Transplantation and Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Sun
authors.affiliation: Shun-Zhen Zheng, Guang-Sheng Yu, Yan-Tian Xu, Wei Gong, Jun Liu, Department of Liver Transplantation and Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China.
authors.forename: Guang-Sheng
authors.initials: GS
authors.lastname: Yu
authors.affiliation: Shun-Zhen Zheng, Guang-Sheng Yu, Yan-Tian Xu, Wei Gong, Jun Liu, Department of Liver Transplantation and Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China.
authors.forename: Yan-Tian
authors.initials: YT
authors.lastname: Xu
authors.affiliation: Shun-Zhen Zheng, Guang-Sheng Yu, Yan-Tian Xu, Wei Gong, Jun Liu, Department of Liver Transplantation and Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Gong
authors.affiliation: Shun-Zhen Zheng, Guang-Sheng Yu, Yan-Tian Xu, Wei Gong, Jun Liu, Department of Liver Transplantation and Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D016461:Chemoembolization, Therapeutic; D017024:Chemotherapy, Adjuvant; D002681:China; D004621:Embolization, Therapeutic; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; 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*; D012189:Retrospective Studies; D012422:Rupture, Spontaneous; D000077157:Sorafenib; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib
keywords: Efficacy; Hepatocellular carcinoma; Safety; Sorafenib; Spontaneous rupture