Arterial blood supply of hepatocellular carcinoma is associated with efficacy of sorafenib therapy

Abstract

Aim: There are some previous reports concerning the relationship between prognosis of patients treated with sorafenib and parameters of computed tomography (CT) and magnetic resonance imaging (MRI). This study presents monocentric experience with sorafenib in the treatment of hepatocellular carcinoma (HCC) patients and will try to identify predictive factors for survival based on the correlation of results from imaging and survival.

Methods: A total of 38 HCC patients treated from April 2009 to December 2010 with sorafenib were included in this study. HCCs were classified as good arterial supply and poor arterial supply according to the enhancement intensity on CT scan or MRI. Clinical data were collected and survival time was analyzed by Kaplan-Meier method. A Cox’s regression model was performed to reveal predictive factors for survival.

Results: Among the 38 patients treated with sorafenib, mean age was 53.3 ± 11.1 years and 35 (92.1%) were males. Tumors in 17 patients were classified as good arterial supply, while the remaining 21 patients belonged to poor arterial supply. The median survival time (MST) was 10.7 months [95% confidence interval (CI), 8.7-12.7] and the 1-year overall survival (OS) was 41.0%. The MST and 1-year OS in patients with a good arterial supply of tumors were 12 months (range: 4-20 months) and 52.9%, compared with that of 7 months (range: 1-16 months) and 23.8% in patients with a poor arterial supply of tumors (P = 0.002). Patients who had tumors at Barcelona Clinic Liver Cancer (BCLC) stage B had longer MST and higher OS than those who had tumors at BCLC stage C, but there was no statistical difference between these two stages. On multivariate analysis, only arterial supply of the tumors remained statistically predictive for OS (hazard ratios 0.22, 95% CI, 0.07-0.67, P = 0.008).

Conclusion: Arterial blood supply is an independent predictor for survival in patients treated with sorafenib, and patients with a good arterial supply of tumors benefit more than those with a poor arterial supply of tumors.

Keywords

Arterial blood supply / hepatocellular carcinoma / sorafenib

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