title: Arterial blood supply of hepatocellular carcinoma is associated with efficacy of sorafenib therapy.
abstract: BACKGROUND
  To explore the efficacy of sorafenib in treating hepatocellular carcinoma (HCC) and its relationship with the computed tomography (CT) and magnetic resonance imaging (MRI) features of HCC, analyze the prognostic factors of HCC patients treated with sorafenib, and investigate the relationship between imaging findings and outcomes.
  
  
  METHODS
  A total of 38 HCC patients who were treated with sorafenib from April 2009 to December 2010 were included in this study. HCCs were classified as good arterial supply and poor arterial supply according to the intensity enhancement on CT scan or MRI. Clinical data were collected and the survival time was calculated by Kaplan-Meier method.
  
  
  RESULTS
  Among these 38 patients [35 (92.1%) were males] treated with sorafenib, the median age was (53.3±11.1) years. Tumors in 17 patients had good arterial supply while those in the remained 21 patients had poor arterial supply. The median survival time (MST) was 10.7 months (95% CI, 8.7-12.7) and the 1-year overall survival (OS) was 41.0%. The MST and 1-year OS in patients with tumors with good arterial supply were 12 months (range, 4-20 months) and 52.9%, respectively, compared with those of 7 months (range, 1-16 months) and 23.8% in patients with tumors with poor arterial supply (P=0.002). Patients with BCLC stage B tumors had longer MST and higher OS than those with BCLC stage C tumors, although the differences were not statistically significant. Multivariate analysis showed that arterial supply of tumors remained statistically predictive for OS (HR =0.22; 95% CI, 0.07-0.67; P=0.008).
  
  
  CONCLUSIONS
  Arterial blood supply is an independent predictor for survival in HCC patients treated with sorafenib, and patients with tumors with good arterial supply benefit more than those with tumors with poor arterial supply.
authors.affiliation: 1 Department of Hepatobiliary Surgery, Jingmen First People's Hospital, Jingmen 448000, China ; 2 Department of Hepatic Surgery I, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Zhu
authors.affiliation: 1 Department of Hepatobiliary Surgery, Jingmen First People's Hospital, Jingmen 448000, China ; 2 Department of Hepatic Surgery I, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China.
authors.forename: Xianghua
authors.initials: X
authors.lastname: Zhang
authors.affiliation: 1 Department of Hepatobiliary Surgery, Jingmen First People's Hospital, Jingmen 448000, China ; 2 Department of Hepatic Surgery I, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: 1 Department of Hepatobiliary Surgery, Jingmen First People's Hospital, Jingmen 448000, China ; 2 Department of Hepatic Surgery I, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Huang
authors.affiliation: 1 Department of Hepatobiliary Surgery, Jingmen First People's Hospital, Jingmen 448000, China ; 2 Department of Hepatic Surgery I, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Yan
authors.affiliation: 1 Department of Hepatobiliary Surgery, Jingmen First People's Hospital, Jingmen 448000, China ; 2 Department of Hepatic Surgery I, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Xu
authors.affiliation: 1 Department of Hepatobiliary Surgery, Jingmen First People's Hospital, Jingmen 448000, China ; 2 Department of Hepatic Surgery I, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China.
authors.forename: Yiqun
authors.initials: Y
authors.lastname: Yan
keywords: Hepatocellular carcinoma (HCC); arterial blood supply; sorafenib