Department of HPB Surgery, Beaujon Hospital, Clichy, France.
Ann Surg Oncol. 2013 Oct;20(11):3603-9. doi: 10.1245/s10434-013-3029-z. Epub 2013 May 29.
Liver resection can be considered in some hepatocellular carcinoma (HCC) patients who received sorafenib. The lack of clinical data about safety of resection after sorafenib treatment led us to assess its potential impact on perioperative course in a multicentric study.
From 2008 to 2011, a total of 23 HCC patients who underwent liver resection after treatment with sorafenib (sorafenib group) were compared with 46 HCC patients (control group) matched for age, gender, underlying liver disease, tumor characteristics and type of resection. Patients received sorafenib for a median duration of 1 (range 0.2-11) months and drug was interrupted at least 7 days before surgery. End points were intraoperative (operative time, vascular clamping, blood loss and transfusion), and postoperative outcomes focusing on recovery of liver function.
In the sorafenib group, HCC was developed on F4 cirrhosis in 48 % and the rate of major resection was 44 %. Surgical procedure duration (280 vs. 240 min), transfusion rate (26 vs. 15 %), blood loss (400 vs. 300 mL) and vascular clamping (70 vs. 74 %) were similar in the two groups. Mortality was zero in the sorafenib group and one (2.1 %) in the control group (p = 1.000). The incidence of postoperative complications was 44 % in the sorafenib group and 59 % in the control group (p = 0.307). Recovery of liver function was similar in the two groups in terms of prothrombin time (90 vs. 81 %, p = 0.429) and bilirubin level (16 vs. 24 μmol/L, p = 102) at postoperative day 5.
No adverse effect of preoperative administration of sorafenib was observed during and immediately after liver resection for HCC.
索拉非尼治疗后可以考虑对某些肝细胞癌（HCC）患者进行肝切除术。由于缺乏索拉非尼治疗后切除的安全性临床数据，我们在一项多中心研究中评估了其对围手术期过程的潜在影响。
2008 年至 2011 年，共对 23 例接受索拉非尼（索拉非尼组）治疗后行肝切除术的 HCC 患者与 46 例匹配年龄、性别、基础肝病、肿瘤特征和切除术类型的 HCC 患者（对照组）进行比较。患者接受索拉非尼治疗的中位时间为 1 个月（范围 0.2-11 个月），手术前至少停药 7 天。终点为术中（手术时间、血管夹闭、出血量和输血）和术后肝功能恢复相关的结局。
在索拉非尼组，48%的 HCC 发生在 F4 肝硬化上，且主要切除率为 44%。两组手术时间（280 比 240 分钟）、输血率（26%比 15%）、出血量（400 比 300 毫升）和血管夹闭（70 比 74%）相似。索拉非尼组死亡率为 0，对照组为 1（2.1%）（p=1.000）。索拉非尼组术后并发症发生率为 44%，对照组为 59%（p=0.307）。两组术后第 5 天的凝血酶原时间（90 比 81%，p=0.429）和胆红素水平（16 比 24μmol/L，p=102）相似。
在 HCC 肝切除术中及术后即刻，术前给予索拉非尼没有观察到不良影响。
