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巴塞罗那临床肝癌C期肝细胞癌患者肝切除术后辅助使用索拉非尼。

Adjuvant sorafenib after heptectomy for Barcelona Clinic Liver Cancer-stage C hepatocellular carcinoma patients.

作者信息

Xia Feng, Wu Li-Li, Lau Wan-Yee, Huan Hong-Bo, Wen Xu-Dong, Ma Kuan-Sheng, Li Xiao-Wu, Bie Ping

机构信息

Feng Xia, Li-Li Wu, Hong-Bo Huan, Xu-Dong Wen, Kuan-Sheng Ma, Xiao-Wu Li, Ping Bie, Institute of Hepatobiliary Surgery, Southwest Hospital, Southwest Cancer Center, Third Military Medical University, Chongqing 400038, China.

出版信息

World J Gastroenterol. 2016 Jun 21;22(23):5384-92. doi: 10.3748/wjg.v22.i23.5384.

Abstract

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.

摘要

目的

探讨索拉非尼辅助治疗对巴塞罗那临床肝癌(BCLC)C期肝细胞癌(HCC)患者根治性切除术后的疗效及安全性。

方法

34例BCLC C期HCC患者在一所三级大学医院接受根治性肝切除术后,因肿瘤复发风险高而接受索拉非尼辅助治疗。将研究组与在研究期间接受HCC根治性肝切除术的68例病例匹配对照组按1:2比例进行比较。

结果

索拉非尼组的肿瘤复发率(15/34,44.1%)明显低于对照组(51/68,75%,P = 0.002)。研究组的无病生存期中位数为12个月,对照组为10个月。单因素分析显示,肿瘤数量超过3个、大血管侵犯、肝门淋巴结转移以及索拉非尼治疗是无病生存期的显著因素。在Cox比例风险模型中,多因素分析显示肿瘤数量超过3个和索拉非尼治疗是无病生存期的显著危险因素。研究组的无病生存期和累积总生存期均显著优于对照组(分别为P = 0.034和0.016)。

结论

我们的研究证实了索拉非尼辅助治疗对降低BCLC C期HCC患者根治性切除术后的HCC复发率、延长无病生存期和总生存期具有潜在益处和安全性。

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