PMID- 24574751
OWN - NLM
STAT- MEDLINE
DCOM- 20141117
LR  - 20211021
IS  - 2219-2840 (Electronic)
IS  - 1007-9327 (Print)
IS  - 1007-9327 (Linking)
VI  - 20
IP  - 3
DP  - 2014 Jan 21
TI  - Predictors of survival in patients with established cirrhosis and hepatocellular 
      carcinoma treated with sorafenib.
PG  - 786-94
LID - 10.3748/wjg.v20.i3.786 [doi]
AB  - AIM: To investigate in greater detail the efficacy and safety of sorafenib for 
      the treatment of hepatocellular carcinoma (HCC) in patients with established 
      cirrhosis. METHODS: From October 2009 to July 2012 patients with an established 
      diagnosis of cirrhosis and HCC treated with sorafenib were consecutively 
      enrolled. According to the Barcelona Clinic Liver Cancer (BCLC) classification, 
      patients were in the advanced stage (BCLC-C) or in the intermediate stage 
      (BCLC-B) but unfit or unresponsive to other therapeutic strategies. Treatment was 
      evaluated performing a 4-phase computed tomography or magnetic resonance imaging 
      scan every 2-3 mo, and analyzed according to the modified Response Evaluation 
      Criteria in Solid Tumors. Sorafenib was administered at 800 mg/d, until 
      radiological progression or occurrence of unacceptable adverse events (AEs). 
      Univariate and multivariate analyses identified predictors of 16-wk clinical 
      benefit and overall survival. RESULTS: Forty-four patients were enrolled, 15 had 
      intermediate HCC and 14 a Child-Pugh score of B7. AEs caused treatment 
      interruption in 19 patients (43%), and median treatment duration was shorter in 
      this subset (5 wk vs 19 wk, P < 0.001) and in the BCLC-C subgroup (13 wk vs 40 
      wk, P = 0.015). No significant differences in the reason for treatment 
      interruption or in treatment duration were found comparing patients in Child-Pugh 
      class A vs B or in patients older or younger than 70 years. After 16 wk of 
      treatment, 18 patients (41%) had stable disease or partial response. Patients 
      with viral infection or BCLC-C were at higher risk of disease progression. ECOG, 
      extrahepatic spread, macrovascular invasion, alpha-fetoprotein or alkaline 
      phosphatase levels at admission were independent predictors of overall survival. 
      CONCLUSION: In patients with cirrhosis and HCC treated with sorafenib, AEs are a 
      common cause of early treatment withdrawal. Vascular invasion and extrahepatic 
      spread condition early response to treatment and survival. Baseline biochemical 
      parameters may be helpful to identify patients at higher risk of shorter overall 
      survival.
FAU - Inghilesi, Andrea L
AU  - Inghilesi AL
AD  - Andrea L Inghilesi, Donatella Gallori, Umberto Arena, Bernardo Fani, Giacomo 
      Laffi, Fabio Marra, Dipartimento di Medicina Sperimentale e Clinica, Universita 
      degli Studi di Firenze, I-50134 Florence, Italy.
FAU - Gallori, Donatella
AU  - Gallori D
AD  - Andrea L Inghilesi, Donatella Gallori, Umberto Arena, Bernardo Fani, Giacomo 
      Laffi, Fabio Marra, Dipartimento di Medicina Sperimentale e Clinica, Universita 
      degli Studi di Firenze, I-50134 Florence, Italy.
FAU - Antonuzzo, Lorenzo
AU  - Antonuzzo L
AD  - Andrea L Inghilesi, Donatella Gallori, Umberto Arena, Bernardo Fani, Giacomo 
      Laffi, Fabio Marra, Dipartimento di Medicina Sperimentale e Clinica, Universita 
      degli Studi di Firenze, I-50134 Florence, Italy.
FAU - Forte, Paolo
AU  - Forte P
AD  - Andrea L Inghilesi, Donatella Gallori, Umberto Arena, Bernardo Fani, Giacomo 
      Laffi, Fabio Marra, Dipartimento di Medicina Sperimentale e Clinica, Universita 
      degli Studi di Firenze, I-50134 Florence, Italy.
FAU - Tomcikova, Daniela
AU  - Tomcikova D
AD  - Andrea L Inghilesi, Donatella Gallori, Umberto Arena, Bernardo Fani, Giacomo 
      Laffi, Fabio Marra, Dipartimento di Medicina Sperimentale e Clinica, Universita 
      degli Studi di Firenze, I-50134 Florence, Italy.
FAU - Arena, Umberto
AU  - Arena U
AD  - Andrea L Inghilesi, Donatella Gallori, Umberto Arena, Bernardo Fani, Giacomo 
      Laffi, Fabio Marra, Dipartimento di Medicina Sperimentale e Clinica, Universita 
      degli Studi di Firenze, I-50134 Florence, Italy.
FAU - Colagrande, Stefano
AU  - Colagrande S
AD  - Andrea L Inghilesi, Donatella Gallori, Umberto Arena, Bernardo Fani, Giacomo 
      Laffi, Fabio Marra, Dipartimento di Medicina Sperimentale e Clinica, Universita 
      degli Studi di Firenze, I-50134 Florence, Italy.
FAU - Pradella, Silvia
AU  - Pradella S
AD  - Andrea L Inghilesi, Donatella Gallori, Umberto Arena, Bernardo Fani, Giacomo 
      Laffi, Fabio Marra, Dipartimento di Medicina Sperimentale e Clinica, Universita 
      degli Studi di Firenze, I-50134 Florence, Italy.
FAU - Fani, Bernardo
AU  - Fani B
AD  - Andrea L Inghilesi, Donatella Gallori, Umberto Arena, Bernardo Fani, Giacomo 
      Laffi, Fabio Marra, Dipartimento di Medicina Sperimentale e Clinica, Universita 
      degli Studi di Firenze, I-50134 Florence, Italy.
FAU - Gianni, Elena
AU  - Gianni E
AD  - Andrea L Inghilesi, Donatella Gallori, Umberto Arena, Bernardo Fani, Giacomo 
      Laffi, Fabio Marra, Dipartimento di Medicina Sperimentale e Clinica, Universita 
      degli Studi di Firenze, I-50134 Florence, Italy.
FAU - Boni, Luca
AU  - Boni L
AD  - Andrea L Inghilesi, Donatella Gallori, Umberto Arena, Bernardo Fani, Giacomo 
      Laffi, Fabio Marra, Dipartimento di Medicina Sperimentale e Clinica, Universita 
      degli Studi di Firenze, I-50134 Florence, Italy.
FAU - Laffi, Giacomo
AU  - Laffi G
AD  - Andrea L Inghilesi, Donatella Gallori, Umberto Arena, Bernardo Fani, Giacomo 
      Laffi, Fabio Marra, Dipartimento di Medicina Sperimentale e Clinica, Universita 
      degli Studi di Firenze, I-50134 Florence, Italy.
FAU - Di Costanzo, Francesco
AU  - Di Costanzo F
AD  - Andrea L Inghilesi, Donatella Gallori, Umberto Arena, Bernardo Fani, Giacomo 
      Laffi, Fabio Marra, Dipartimento di Medicina Sperimentale e Clinica, Universita 
      degli Studi di Firenze, I-50134 Florence, Italy.
FAU - Marra, Fabio
AU  - Marra F
AD  - Andrea L Inghilesi, Donatella Gallori, Umberto Arena, Bernardo Fani, Giacomo 
      Laffi, Fabio Marra, Dipartimento di Medicina Sperimentale e Clinica, Universita 
      degli Studi di Firenze, I-50134 Florence, Italy.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - World J Gastroenterol
JT  - World journal of gastroenterology
JID - 100883448
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Phenylurea Compounds)
RN  - 0 (Protein Kinase Inhibitors)
RN  - 25X51I8RD4 (Niacinamide)
RN  - 9ZOQ3TZI87 (Sorafenib)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Agents/adverse effects/*therapeutic use
MH  - Carcinoma, Hepatocellular/*drug therapy/etiology/mortality/pathology
MH  - Chi-Square Distribution
MH  - Female
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Liver Cirrhosis/*complications/mortality
MH  - Liver Neoplasms/*drug therapy/etiology/mortality/pathology
MH  - Logistic Models
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Neoplasm Staging
MH  - Niacinamide/adverse effects/*analogs & derivatives/therapeutic use
MH  - Phenylurea Compounds/adverse effects/*therapeutic use
MH  - Proportional Hazards Models
MH  - Protein Kinase Inhibitors/adverse effects/*therapeutic use
MH  - Risk Factors
MH  - Sorafenib
MH  - Time Factors
MH  - Tomography, X-Ray Computed
MH  - Treatment Outcome
PMC - PMC3921487
OTO - NOTNLM
OT  - Adverse events
OT  - Barcelona Clinic Liver Cancer
OT  - Cirrhosis
OT  - Hepatocellular carcinoma
OT  - Sorafenib
EDAT- 2014/02/28 06:00
MHDA- 2014/11/18 06:00
PMCR- 2014/01/21
CRDT- 2014/02/28 06:00
PHST- 2013/05/20 00:00 [received]
PHST- 2013/08/19 00:00 [revised]
PHST- 2013/08/28 00:00 [accepted]
PHST- 2014/02/28 06:00 [entrez]
PHST- 2014/02/28 06:00 [pubmed]
PHST- 2014/11/18 06:00 [medline]
PHST- 2014/01/21 00:00 [pmc-release]
AID - 10.3748/wjg.v20.i3.786 [doi]
PST - ppublish
SO  - World J Gastroenterol. 2014 Jan 21;20(3):786-94. doi: 10.3748/wjg.v20.i3.786.