Published online Jun 21, 2016. doi: 10.3748/wjg.v22.i23.5384
Peer-review started: March 7, 2016
First decision: March 21, 2016
Revised: March 27, 2016
Accepted: April 20, 2016
Article in press: April 20, 2016
Published online: June 21, 2016
AIM: To investigate the efficacy and safety of adjuvant sorafenib after curative resection for patients with Barcelona Clinic Liver Cancer (BCLC)-stage C hepatocellular carcinoma (HCC).
METHODS: Thirty-four HCC patients, classified as BCLC-stage C, received adjuvant sorafenib for high-risk of tumor recurrence after curative hepatectomy at a tertiary care university hospital. The study group was compared with a case-matched control group of 68 patients who received curative hepatectomy for HCC during the study period in a 1:2 ratio.
RESULTS: The tumor recurrence rate was markedly lower in the sorafenib group (15/34, 44.1%) than in the control group (51/68, 75%, P = 0.002). The median disease-free survival was 12 mo in the study group and 10 mo in the control group. Tumor number more than 3, macrovascular invasion, hilar lymph nodes metastasis, and treatment with sorafenib were significant factors of disease-free survival by univariate analysis. Tumor number more than 3 and treatment with sorafenib were significant risk factors of disease-free survival by multivariate analysis in the Cox proportional hazards model. The disease-free survival and cumulative overall survival in the study group were significantly better than in the control group (P = 0.034 and 0.016, respectively).
CONCLUSION: Our study verifies the potential benefit and safety of adjuvant sorafenib for both decreasing HCC recurrence and extending disease-free and overall survival rates for patients with BCLC-stage C HCC after curative resection.
Core tip: Hepatocellular carcinoma (HCC) has a 5-year recurrence rate reaching 80%-90% even after potentially curative treatment. Therefore, it is extremely important to prevent recurrence for the prognosis of HCC patients. Sorafenib is the only approved treatment for patients with advanced HCC. Thus, based on the action of sorafenib, namely inhibition of tumor cell proliferation and angiogenesis, there is rationale for the study of sorafenib as an adjuvant therapy in HCC. It is essential to investigate the efficacy and safety of adjuvant sorafenib administered following curative resection in patients with Barcelona Clinic Liver Cancer-stage C HCC.