title: Prognostic factors in patients with hepatocellular carcinoma refractory or intolerant to sorafenib.
abstract: OBJECTIVE
  The aim of this study was to identify the prognostic factors in patients with advanced hepatocellular carcinoma (HCC) who are refractory or intolerant to sorafenib and to exclude unsuitable candidates from subsequent therapy.
  
  
  METHODS
  The study cohort consisted of 111 patients who had discontinued sorafenib therapy. Uni- and multivariate analyses were conducted to identify the prognostic factors for survival after discontinuation of sorafenib therapy.
  
  
  RESULTS
  The median age of the patients was 70 years, and 96 of them (86%) were male. The Eastern Cooperative Oncology Group performance status was 0-1 in 94 patients (85%). Forty patients (36%) were classified as Child-Pugh class A and 57 (51%) as Child-Pugh class B. The median survival time after discontinuation of sorafenib therapy was 146 days. Hepatitis C viral antibody negativity, presence of ascites, absence of a history of previous treatment excluding sorafenib, elevated serum total bilirubin level, and elevated serum α-fetoprotein level were identified as the independent unfavorable prognostic factors by multivariate analysis. The median survival time of the patients with 4 or 5 unfavorable prognostic factors was 59 days.
  
  
  CONCLUSIONS
  We should judge the indication of any subsequent therapy carefully in patients with 4 or 5 of the aforementioned factors.
authors.affiliation: Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okuyama
authors.forename: Masafumi
authors.initials: M
authors.lastname: Ikeda
authors.forename: Akiko
authors.initials: A
authors.lastname: Kuwahara
authors.forename: Hideaki
authors.initials: H
authors.lastname: Takahashi
authors.forename: Izumi
authors.initials: I
authors.lastname: Ohno
authors.forename: Satoshi
authors.initials: S
authors.lastname: Shimizu
authors.forename: Shuichi
authors.initials: S
authors.lastname: Mitsunaga
authors.forename: Shoichi
authors.initials: S
authors.lastname: Senda
authors.forename: Takuji
authors.initials: T
authors.lastname: Okusaka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D015331:Cohort Studies; D019008:Drug Resistance, Neoplasm; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D009536:Niacinamide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000627:therapeutic use*; D011379:Prognosis; D000077157:Sorafenib; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib