Retrospective Study
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World J Gastroenterol. Nov 21, 2014; 20(43): 16275-16281
Published online Nov 21, 2014. doi: 10.3748/wjg.v20.i43.16275
Feasibility and safety of sorafenib treatment in hepatocellular carcinoma patients with spontaneous rupture
Shun-Zhen Zheng, De-Jie Liu, Ping Sun, Guang-Sheng Yu, Yan-Tian Xu, Wei Gong, Jun Liu
Shun-Zhen Zheng, Guang-Sheng Yu, Yan-Tian Xu, Wei Gong, Jun Liu, Department of Liver Transplantation and Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China
De-Jie Liu, Department of Anesthesiology, Qilu Hospital, Shandong University, Jinan 250012, Shandong Province, China
Ping Sun, Department of Biochemistry and Molecular Biology, Shandong University School of Medicine, Jinan 250012, Shandong Province, China
Author contributions: Liu J and Zheng SZ designed the research; Zheng SZ, Liu DJ, Sun P and Yu GS performed the research; Xu YT and Gong W analyzed the data; Zheng SZ wrotes the manuscript.
Supported by National Natural Science Foundation of China, No. 81302124
Correspondence to: Jun Liu, Professor, Department of Liver Transplantation and Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong University, No. 324 Jingwu Road, Jinan 250021, Shandong Province, China. dr_liujun@hotmail.com
Telephone: +86-531-68776932 Fax: +86-531-87925615
Received: June 16, 2014
Revised: July 21, 2014
Accepted: August 13, 2014
Published online: November 21, 2014
Processing time: 157 Days and 12.6 Hours
Abstract

AIM: To report the outcome of patients with ruptured hepatocellular carcinoma (HCC) treated at a single center during a 5-year period.

METHODS: We retrospectively analyzed 32 patients who presented with ruptured HCC at Shandong Provincial Hospital Affiliated to Shandong University between 2008 and 2013.

RESULTS: The mean age of the patients was 53 years (range 39-71 years). Of these patients, 22 received surgical management, 10 underwent transarterial embolization (TAE) or transarterial chemoembolization (TACE), and 12 received sorafenib after surgery, TAE or TACE. Cumulative survival rates at 4, 8 and 12 mo were 72.9%, 50.0% and 33.3%, respectively, in the surgery only group and were 90.0%, 80.6% and 64.1%, respectively, in the surgery plus sorafenib group. Cumulative survival rates at 4, 8 and 12 mo were 68.4%, 43.6% and 19.4%, respectively, in the surgery only or TAE/TACE only groups, and were 91.7%, 75.0% and 60.2%, respectively, in the sorafenib combination groups (P = 0.04). No unexpected side effects due to sorafenib were observed. The most common side effect was hand-foot skin reaction. To date, 5 patients have died. Median follow-up from the start of sorafenib therapy for the remaining 7 patients is 12.7 mo (range 5.8-32.2 mo).

CONCLUSION: Sorafenib can be used in patients with ruptured HCC as it has interesting activity and is well tolerated; dose adjustment is generally not required. However, a larger prospective study is necessary to determine the efficacy of sorafenib in this group of patients.

Keywords: Sorafenib; Hepatocellular carcinoma; Spontaneous rupture; Efficacy; Safety

Core tip: Spontaneous rupture of hepatocellular carcinoma (HCC) is a life-threatening condition. Currently, sorafenib is available for HCC patients with spontaneous rupture, although its efficacy and safety have not been reported. This study aims to report the outcome of patients with ruptured HCC in a single center during a 5-year period. We retrospectively analyzed 32 patients who presented with ruptured HCC at our institute between 2008 and 2013. We concluded that sorafenib can be used in patients with ruptured HCC as it has interesting activity and is well tolerated. However, a larger prospective study is necessary to determine the efficacy of sorafenib in this group of patients.