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test was performed to test for homogeneity of Table 1: Baseline characteristics of 38 patients included in
variances. Homogeneous variances were indicated the study
as a mean plus or minus SD (mean ± SD) and the Variable n = 38
Sex (male/female)
35/3
Student’s t-test was used for statistical analysis. If Age (years) 53.3 ± 11.1
ECOG PS
the variances were not homogeneous, they were 0 32
1
presented as median in combination with the BCLC stage 6
range. Categorical variables were compared using B 18
20
C
the Chi-square test with Yates correction or the Arterial supply of the tumor
17
Fisher exact test where appropriate. P < 0.05 was Good 21
Poor
considered significantly. Hazard ratios (HRs) and Portal invasion
their corresponding 95% confidence interval (CI) were Yes 14
24
No
calculated using simple logistic-regression analysis. Extrahepatic metastasis 9
Yes
No 29
Survival rates were obtained by the Kaplan-Meier Collaborative treatment 30
TACE
None
method and were compared using the log-rank Hepatitis background 8
test. Cox regression model was used to analyze the Hepatitis B 36
Hepatitis C
prognostic predictors for survival. Survival time Vascular thrombus 2
started from the date of treatment with sorafenib Presence 12
26
Absence
until death or the closing date. The closing date of Tumor size 8.1 ± 3.1
this study was August 31, 2011. AFP (ng/mL) 205.1 (2-2,483,000)
15.0 ± 7.6
Total bilirubin (umol/L)
Albumin (g/L) 39.3 ± 4.6
RESULTS Pre-albumin (mg/L) 144.0 ± 46.0
48.3 ± 65.9
ALT (IU/L)
AST (IU/L) 55.3 ± 49.3
12.5 ± 1.1
Baseline characteristics PT (s) 5.43 ± 0.69
BUN (mmol/L)
Among the 38 patients treated with sorafenib, mean Cr (umol/L) 69.18 ± 11.61
age was 53.3 ± 11.1 years and 35 (92.1%) were males. ECOG PS: Eastern Cooperative Oncology Group Performance Status; BCLC:
Barcelona Clinic Liver Cancer; TACE: transarterial chemoembolization;
All the patients had viral hepatitis background, with AFP: alpha-fetoprotein; ALT: alanine aminotransferase; AST: aspartate
a hepatitis B prevalence of 94.7%. The baseline aminotransferase; PT: prothrombin time; BUN: blood urea nitrogen; Cr: creatinine
characteristics of the 38 patients are shown in Table 12.7) and the 1-year OS was 41.0%. On univariate
1. Tumors in 17 patients were classified as good analysis [Table 2], the MST and 1-year OS in patients
arterial supply while the other patients belonged with good arterial supply of tumors were 12 months
to poor arterial supply according to the judgment (range: 4-20 months) and 52.9%, compared with
of the radiologist. A total of 30 patients received 1 that of 7 months (range: 1-16 months) and 23.8% in
time additional therapy of TACE during the period of patients with poor arterial supply of tumors (P =
follow-up, of which 13 patients with a good arterial 0.002). Similarly, patients who had tumors at BCLC
supply of the tumors and 17 with poor arterial supply. stage B had longer MST and higher OS than those
who had tumors at BCLC stage C. However, there was
Safety and adverse events no statistically significant difference between these
Each patient experienced at least one adverse event two stages.
in the duration of sorafenib administration. Hand-
foot skin reaction and diarrhea were the most Eight variables were selected on multivariate analysis
common discomforts complained by the patients. to determine the prognostic predictors for survival
Less common adverse effects included fatigue, in patients treated with sorafenib [Table 3]. Only
alopecia, hypertension, and diabetes. A total of 6 arterial supply of the tumors remained statistically
patients had dose reduction due to severe adverse predictive for OS (HR: 0.22, 95% CI, 0.07-0.67, P =
events, of which 3 for diarrhea and 3 for hand- 0.008).
foot skin reaction. None of the patients had drug
discontinuation. DISCUSSION

Survival analysis As a highly vascularized neoplasm, most HCCs exert
At the closing date of this study, 29 (76.3%) patients imaging characteristics of intense contrast uptake
died and 9 patients were still alive. The median in the arterial phase, followed by contrast washout
survival time (MST) was 10.7 months (95% CI, 8.7- in the delayed venous phase at dynamic imaging by

Hepatoma Research | Volume 2 | April 1, 2016 89