Z Gastroenterol 2011; 49 - P17
DOI: 10.1055/s-0031-1279854

Prognostic factors in patients with hepatocellular carcinoma treated with Sorafenib

M Pinter 1, W Sieghart 1, F Hucke 1, I Graziadei 1, W Vogel 1, A Maieron 1, R Königsberg 1, A Weissmann 1, G Kornek 1, J Matejka 1, R Stauber 1, R Buder 1, B Grünberger 1, M Schöniger-Hekele 1, C Müller 1, M Peck-Radosavljevic 1
  • 1Dept. of Gastroenterology and Hepatology, AKH & Medizinische Universität Wien; Dept. of Gastroenterology and Hepatology, LKH & Medizinische Universität Innsbruck; Fourth Medical Department, KH Elisabethinen Linz; Kaiser Franz Josef-Spital, Third Medical Department, Centre for Oncology and Hematology, CEADDP, Applied Cancer Research, Institution for Translational Research Vienna (ACR-ITR VIEnna), and Ludwig Boltzmann-Institute for Applied Cancer Research (LBI-ACR VIEnna), Vienna, Austria; Dept. of Oncology and Hematology, Wilhelminenspital Wien; Dept. of Oncology, AKH & Medizinische Universität Wien; Dept. of Gastroenterology & Hepatology, LKH & Medizinische Universität Graz; Dept. of Internal Medicine, KH Barmherzige Brüder Linz; Dept. of Internal Medicine, KH Barmherzige Brüder Wien

Purpose: We aimed to identify prognostic factors for patients with hepatocellular carcinoma (HCC) treated with sorafenib and to evaluate the efficacy of sorafenib with respect to liver function.

Patients and methods: In this retrospective study, 148 HCC patients received sorafenib 400mg bid in 11 Austrian institutions. Seventy-eight HCC patients treated with best supportive care (BSC) in the pre-sorafenib era served as control.

Results: Child-Pugh (CP) stage A/B for HCC patients within Barcelona Clinic Liver Cancer (BCLC) stage B and C was n=76/55 for sorafenib and n=17/22 for BSC. Seventeen (sorafenib) and 39 (BSC) patients had end-stage (BCLC D) HCC. In sorafenib patients, low baseline α-Fetoprotein, low CP-stage, compensated cirrhosis, and low baseline aspartate aminotransferase (AST) were associated with a significantly longer overall survival (OS) on univariate analysis. CP-stage and baseline AST were independent prognostic factors on multivariate analysis.

Within BCLC stage B and C, CPA-patients had a median OS of 11.3 (sorafenib) vs. 6.4 (BSC) months (p=0.010); for CPB-patients, median OS for sorafenib vs. BSC was 5.5 vs. 1.9 months (p=0.021). In end-stage HCC (BCLC D), no survival difference was observed between sorafenib and BSC patients (1.5 vs. 1.4 months; p=0.116).

In the sorafenib group (BCLC B, C), the strongest discriminative power of AST for OS was observed in CPB-patients (AST <100 vs. ≥100U/l, 6.5 vs. 2.1 months; p=0.011).

Conclusion: Sorafenib proglongs survival in HCC patients with CPA cirrhosis. In CPB-patients, baseline AST is the best parameter to select patients prior to initiation of sorafenib.