Li Qingli, Song Tianqiang
Department of Hepatobiliary Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
Front Oncol. 2021 Sep 23;11:633033. doi: 10.3389/fonc.2021.633033. eCollection 2021.
The use of sorafenib in the adjuvant management of hepatocellular carcinoma (HCC) is controversial.
To analyze the effects of adjuvant sorafenib therapy in patients with HCC at high recurrence risk after radical resection.
This was a retrospective study of patients who underwent radical resection (R0 resection) for HCC at the Cancer Hospital of Tianjin Medical University between August 2009 and August 2017. All patients had microvascular invasion and were evaluated for portal vein tumor thrombus. The outcomes were overall survival (OS), recurrence-free survival (RFS), and survival after recurrence. Propensity score matching (PSM) was used.
Before matching, there were 56 and 167 patients in the sorafenib and non-sorafenib groups. After PSM, there were 42 patients/group, and there were no significant differences in patient characteristics (all P>0.05). After PSM, compared with the non-sorafenib group, the sorafenib group showed longer median OS (34 26 months, P=0.032) and survival after recurrence (16 9 months, P=0.002), but no difference in RFS (14 11 months, P=0.564). Adjuvant sorafenib was the only factor independently associated with OS (HR=0.619, 95% CI: 0377-0.994, P=0.047). No factors were independently associated with RFS (all P>0.05).
Although adjuvant sorafenib therapy for patients with HCC and high recurrence risk does not reduce the recurrence risk of HCC, it might be associated with longer survival and a lower risk of death.
索拉非尼在肝细胞癌(HCC)辅助治疗中的应用存在争议。
分析辅助索拉非尼治疗对根治性切除术后高复发风险HCC患者的影响。
这是一项对2009年8月至2017年8月在天津医科大学肿瘤医院接受HCC根治性切除(R0切除)患者的回顾性研究。所有患者均有微血管侵犯,并评估门静脉癌栓情况。观察指标为总生存期(OS)、无复发生存期(RFS)和复发后生存期。采用倾向评分匹配(PSM)。
匹配前,索拉非尼组和非索拉非尼组分别有56例和167例患者。PSM后,每组各有42例患者,患者特征无显著差异(均P>0.05)。PSM后,与非索拉非尼组相比,索拉非尼组的中位OS更长(34对26个月,P=0.032),复发后生存期更长(16对9个月,P=0.002),但RFS无差异(14对11个月,P=0.564)。辅助索拉非尼是唯一与OS独立相关的因素(HR=0.619,95%CI:0.377-0.994,P=0.047)。无因素与RFS独立相关(均P>0.05)。
虽然辅助索拉非尼治疗不能降低高复发风险HCC患者的复发风险,但可能与更长的生存期和更低的死亡风险相关。