Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University; Division of Hepato-biliary-pancreatic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Hepatol Res. 2014 May;44(5):523-31. doi: 10.1111/hepr.12159. Epub 2013 Jun 13.
Until now, no effective adjuvant therapy to prevent early recurrence of hepatocellular carcinoma (HCC) after curative treatment has been reported. The aim of this study is to evaluate the clinical benefit of sorafenib as adjuvant treatment in subjects with HCC after hepatic resection.
The pilot study was undertaken involving HCC patients who had undergone curative liver surgery with high recurrence risk factors. Time to recurrence and disease recurrence rate were assessed. Sorafenib 400 mg q.d. was administrated continuously for 4 months after hepatic resection.
A total of 31 patients were enrolled and eligible for final data analysis. The median follow-up time was 19 months (range, 9.5-30.2). Time to recurrence in the sorafenib arm was 21.45 ± 1.98 months (mean ± standard deviation), compared to 13.44 ± 2.66 months in the control arm (P = 0.006). The median recurrence-free survival in the sorafenib arm did not reach the data cut-off date compared to 8 months in the control arm (P = 0.006). The recurrence rate between the two groups was significantly different (29.4% vs 70.7%, P = 0.032). Cox regression analysis showed that taking study medicine was the only prognostic variable associated with HCC recurrence (hazard ratio = 0.24, 95% confidence interval = 0.08-0.75, P = 0.014).
This study showed that setting sorafenib as adjuvant therapy for HCC to prevent early recurrence after hepatic resection could be a potential indication. The cumulative recurrence-free survival rate also demonstrated the preventive effectiveness of sorafenib.
迄今为止,尚无有效的辅助治疗方法可预防根治性治疗后肝细胞癌(HCC)的早期复发。本研究旨在评估索拉非尼作为HCC 患者肝切除术后辅助治疗的临床获益。
本研究为前瞻性研究,纳入了具有高复发风险因素的接受根治性肝切除术的 HCC 患者。评估复发时间和疾病复发率。肝切除术后连续 4 个月每天给予索拉非尼 400mg。
共纳入 31 例患者,最终均符合纳入排除标准。中位随访时间为 19 个月(9.5-30.2 个月)。索拉非尼组的复发时间为 21.45±1.98 个月,对照组为 13.44±2.66 个月(P=0.006)。索拉非尼组的中位无复发生存期未达到数据截止日期,而对照组为 8 个月(P=0.006)。两组的复发率差异有统计学意义(29.4% vs 70.7%,P=0.032)。Cox 回归分析显示,服用研究药物是与 HCC 复发相关的唯一预后变量(风险比=0.24,95%置信区间=0.08-0.75,P=0.014)。
本研究表明,将索拉非尼作为 HCC 肝切除术后预防早期复发的辅助治疗可能是一种潜在的适应证。累积无复发生存率也证明了索拉非尼的预防效果。