title: Comparison of Outcome of Hepatic Arterial Infusion Chemotherapy and Sorafenib in Patients with Hepatocellular Carcinoma Refractory to Transcatheter Arterial Chemoembolization.
abstract: OBJECTIVE
  To compare the outcome of 5-fluorouracil (FU)-based hepatic arterial infusion chemotherapy (HAIC) with sorafenib monotherapy in patients with hepatocellular carcinoma (HCC) refractory to transcatheter arterial chemoembolization (TACE).
  
  
  METHODS
  In this retrospective cohort study, 123 patients with HCC refractory to TACE, with Child-Pugh A and free of extrahepatic metastasis, were divided into two groups: 65 received HAIC and 58 received sorafenib. Since the size of main tumor and portal vein invasion were significantly different between the HAIC and sorafenib groups, we selected 48 patients from the 65 patients of the HAIC group and 48 from the 58 patients of the sorafenib group. The model used one-to-one matching between the two groups using the case-control method matching method. The clinical characteristics of patients of the case-control HAIC (n=48) and sorafenib groups (n=48) were similar. Overall survival, time to progression and time to treatment failure (TTTF) were compared between the two groups.
  
  
  RESULTS
  The median survival time and TTTF were significantly longer in the sorafenib group than in the HAIC group (15 and 12.2 months versus 8 and 4.4 months, respectively; p=0.021 and p=0.002, respectively). Multivariate analysis identified male gender (p=0.008), relative tumor size <50% (p=0.012), α-fetoprotein <400 ng/ml (p=0.005), and treatment with sorafenib (p=0.001) as significant and independent determinants of better overall survival.
  
  
  CONCLUSIONS
  In patients with HCC refractory to TACE, overall survival was favorable in those treated with sorafenib rather than HAIC.
authors.affiliation: Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hatooka
authors.affiliation: Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Kawaoka
authors.affiliation: Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan aikata@hiroshima-u.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Aikata
authors.affiliation: Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Morio
authors.affiliation: Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Hiramatsu
authors.affiliation: Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Michio
authors.initials: M
authors.lastname: Imamura
authors.affiliation: Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Yoshiiku
authors.initials: Y
authors.lastname: Kawakami
authors.affiliation: Hiroshima City Asa Hospital, Hiroshima, Japan.
authors.forename: Eisuke
authors.initials: E
authors.lastname: Murakami
authors.affiliation: Hiroshima City Asa Hospital, Hiroshima, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Waki
authors.affiliation: Hiroshima Red Cross Hospital, Hiroshima, Japan.
authors.forename: Yoji
authors.initials: Y
authors.lastname: Honda
authors.affiliation: Hiroshima Red Cross Hospital, Hiroshima, Japan.
authors.forename: Nami
authors.initials: N
authors.lastname: Mori
authors.affiliation: Hiroshima Red Cross Hospital, Hiroshima, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Takaki
authors.affiliation: Hiroshima Red Cross Hospital, Hiroshima, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Tsuji
authors.affiliation: Kure Medical Center, Hiroshima, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Kohno
authors.affiliation: Kure Medical Center, Hiroshima, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kohno
authors.affiliation: Chugoku Rousai Hospital, Hiroshima, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Moriya
authors.affiliation: Hiroshima General Hospital, Hiroshima, Japan.
authors.forename: Michihiro
authors.initials: M
authors.lastname: Nonaka
authors.affiliation: Hiroshima General Hospital, Hiroshima, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Hyogo
authors.affiliation: Hiroshima General Hospital, Hiroshima, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Aisaka
authors.affiliation: Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D019008:Drug Resistance, Neoplasm; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006499:Hepatic Artery / Q000473:pathology; D006801:Humans; D007261:Infusions, Intra-Arterial; D007372:Interferons / Q000008:administration & dosage; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009536:Niacinamide / Q000008:administration & dosage / Q000031:analogs & derivatives*; D010671:Phenylurea Compounds / Q000008:administration & dosage*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D000077157:Sorafenib; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D007372:Interferons; D000077157:Sorafenib; D005472:Fluorouracil
keywords: HCC; hepatic arterial infusion chemotherapy; sorafenib; transcatheter arterial chemoembolization