title: The Impact of Combined Transarterial Chemoembolization on the Overall Survival of Patients with Advanced Hepatocellular Carcinoma Treated with Sorafenib.
abstract: OBJECTIVE
  Sorafenib has been proved to prolong survival of patients with advanced hepatocellular carcinoma (HCC), but with moderate efficacy. The present study aimed to evaluate the prognostic factors for overall survival (OS) in Chinese patients with advanced HCC treated with sorafenib who had been refractory to transarterial chemoembolization (TACE) and identify the impact of combined TACE on OS.
  
  
  METHODS
  29 cases with advanced HCC treated with sorafenib between Feb 2009 and Sep 2012 who had been treated with TACE and finally failed to respond to TACE were included in the analysis. The survival was analysed by Kaplan-Meier Method. The clinical parameters were analysed by univariate and multivariate analysis to determine the prognostic factors of OS.
  
  
  RESULTS
  Median OS of the whole cohort was 11.867 months. Combined TACE and ALB > 39.4 g/L were the independent prognostic factors associated with improved OS while Barcelona Clinic Liver Cancer (BCLC) stage C was associated with reduced OS. The overall incidence of sorafenib-related adverse effects was 82.8% and most were mild.
  
  
  CONCLUSIONS
  Albumin and combined TACE is associated with improved OS in patients with advanced HCC treated with sorafenib who had been refractory to TACE. While, BCLC stage C is an independent negative prognostic factor for the OS.
authors.forename: Lufeng
authors.initials: L
authors.lastname: Chen
authors.forename: Hongying
authors.initials: H
authors.lastname: Su
authors.forename: Haibo
authors.initials: H
authors.lastname: Shao
authors.forename: Ke
authors.initials: K
authors.lastname: Xu
authors.forename: Songnian
authors.initials: S
authors.lastname: Liang
authors.forename: Jing
authors.initials: J
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000401:mortality; D002681:China; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009536:Niacinamide / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D016016:Proportional Hazards Models; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D012307:Risk Factors; D000077157:Sorafenib; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors; D009536:Niacinamide; D000077157:Sorafenib