title: Regional differences in sorafenib-treated patients with hepatocellular carcinoma: GIDEON observational study.
abstract: Treatment approaches for hepatocellular carcinoma (HCC) vary across countries, but these differences and their potential impact on outcomes have not been comprehensively assessed. Data from the multinational GIDEON (Global Investigation of therapeutic DEcisions in HCC and Of its treatment with sorafeNib) registry evaluated differences in patient characteristics, practice patterns and outcomes in HCC across geographical regions in patients who received sorafenib.
  
  
  
  GIDEON is a non-randomised, observational registry study conducted in 39 countries across five global regions. HCC patients in whom a decision to treat with sorafenib was made in clinical practice and according to local practices were included.
  
  
  
  3202 patients were evaluable for safety analysis: Asia-Pacific (n = 928), Japan (n = 508), Europe (n = 1113), USA (n = 563) and Latin America (n = 90). Patients in Japan had earlier-stage disease at initial diagnosis compared with patients in other regions (Barcelona Clinic Liver Cancer stage A; 43.7% vs 9.1-24.3%). Use of locoregional therapies before sorafenib, including transarterial chemoembolisation, was more common in Japan (84.4%) and Asia-Pacific (67.2%) compared with the USA (49.4%) and Europe (43.5%). Treatment patterns with respect to sorafenib also differed, with a shorter duration of treatment reported in the USA and Asia-Pacific. Time from initial diagnosis to death was longer in Japan compared with other regions (median, 79.6 months vs 14.8-25.0 months).
  
  
  
  Data from GIDEON highlight regional variations in the management of HCC and patient outcomes. Greater standardisation of management may help optimise outcomes for HCC patients.
authors.affiliation: Department of Gastroenterology and Hepatology, Kinki University School of Medicine, Osaka, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kudo
authors.affiliation: Division of Diagnostic Imaging and Intervention, Pisa University Hospital and School of Medicine, Pisa, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Lencioni
authors.affiliation: Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Marrero
authors.affiliation: University of California, San Francisco, CA, USA.
authors.forename: Alan P
authors.initials: AP
authors.lastname: Venook
authors.affiliation: Department of Gastroenterology and Hepatology, INSERM U954, University Hospital, University of Lorraine, Nancy, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Bronowicki
authors.affiliation: Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Xiao-Ping
authors.initials: XP
authors.lastname: Chen
authors.affiliation: Policlínica Metropolitana, Caracas, Venezuela.
authors.forename: Lucy
authors.initials: L
authors.lastname: Dagher
authors.affiliation: Kyorin University School of Medicine, Tokyo, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Furuse
authors.affiliation: Vascular and Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Jean-Francois H
authors.initials: JF
authors.lastname: Geschwind
authors.affiliation: Hospital Angeles Clínica Londres, Mexico City, Mexico.
authors.forename: Laura
authors.initials: L
authors.lastname: Ladrón de Guevara
authors.affiliation: University Hospital of Larissa, Larissa, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Papandreou
authors.affiliation: Virginia Commonwealth University Medical Center, Richmond, VA, USA.
authors.forename: Arun J
authors.initials: AJ
authors.lastname: Sanyal
authors.affiliation: Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Tadatoshi
authors.initials: T
authors.lastname: Takayama
authors.affiliation: The Catholic University of Korea, Seoul, Korea.
authors.forename: Seung Kew
authors.initials: SK
authors.lastname: Yoon
authors.affiliation: Global Medical Affairs, Bayer HealthCare Pharmaceuticals, Whippany, NJ, USA.
authors.forename: Keiko
authors.initials: K
authors.lastname: Nakajima
authors.affiliation: Clinical Statistics, Bayer HealthCare Pharmaceuticals, Whippany, NJ, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Lehr
authors.affiliation: Global Medical Affairs and Pharmacovigilance, Bayer Pharma AG, Berlin, Germany.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Heldner
authors.affiliation: Liver Cancer Institute and Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Sheng-Long
authors.initials: SL
authors.lastname: Ye
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D019468:Disease Management; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D055088:Early Detection of Cancer; D005060:Europe; D005260:Female; D006801:Humans; D007564:Japan; D008113:Liver Neoplasms / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009536:Niacinamide / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010139:Pacific Islands; D010671:Phenylurea Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D012042:Registries; D000077157:Sorafenib; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib
keywords: GIDEON; Nexavar; hepatocellular carcinoma; liver; sorafenib