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An Analysis for Survival Predictors for Patients with Hepatocellular Carcinoma Who Failed to Sorafenib Treatment in Pre-regorafenib EraAn Analysis for Survival Predictors for Patients with Hepatocellular Carcinoma Who Failed to Sorafenib Treatment in Pre-regorafenib Era

Other Titles
An Analysis for Survival Predictors for Patients with Hepatocellular Carcinoma Who Failed to Sorafenib Treatment in Pre-regorafenib Era
Authors
Chan Uk LeeYoung-Sun LeeJi Hoon KimMinjin LeeSehwa KimYoung Kul JungYeon Seok SeoHyung Joon YimJong Eun YeonKwan Soo Byun
Issue Date
2019
Publisher
대한간암학회
Keywords
Hepatocellular carcinoma; Sorafenib; Chemotherapy
Citation
Journal of Liver Cancer, v.19, no.2, pp.117 - 127
Indexed
KCI
Journal Title
Journal of Liver Cancer
Volume
19
Number
2
Start Page
117
End Page
127
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/2622
ISSN
2288-8128
Abstract
Background/Aims: Sorafenib is the standard treatment for patients with advanced hepatocellular carcinoma (HCC). We aimed to investigate the prognosis predictors and the role of second-line cytotoxic systemic chemotherapy (CSC) in patients with advanced HCC after sorafenib discontinuation in the pre-regorafenib era. Methods: From 2007 to 2015 in the pre-regorafenib era, the medical records of 166 HCC patients, who had permanently discontinued sorafenib, were retrospectively reviewed. For further analysis of survival factors after sorafenib treatment failure, we compared the survival of patients who had maintained liver function after second-line treatment with the best supportive care (BSC) group and selective BSC (SBSC) group. Results: After discontinuation of sorafenib, median overall survival (OS) was 2.8 (1.9-3.7) months. The OS in patients who discontinued sorafenib due to adverse effect, progression, and poor clinical condition were 5.5 (2.4-8.6), 5.5 (2.2-8.9), and 0.9 (0.5-1.3) months, respectively (P<0.001). The independent predictive factors of survival after sorafenib failure were serum level of bilirubin and albumin, α-fetoprotein, discontinuation cause, and second-line CSC. In comparison with survival between second-line CSC and BSC group, the CSC group showed better survival outcome compared to the BSC group (10.6 vs. 1.6 months, P<0.001) and SBSC group (10.6 vs. 4.2 months, P=0.023). Conclusions: The survival after sorafenib failure in patients who discontinued sorafenib due to progression and adverse effects was significantly better than in those who discontinued treatment due to clinical deterioration. In the pre-regorafenib era, patients who received second-line CSC showed better survival than those who received only supportive care after sorafenib failure.
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Kim, Ji Hoon
구로병원 (Department of Gastroenterology and Hepatology, Guro Hospital)
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