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Hung et al. Hepatoma Res 2017;3:52-7 Hepatoma Research
DOI: 10.20517/2394-5079.2016.43
www.hrjournal.net
Original Article Open Access
Attenuation of liver stiffness in

sorafenib-treated patients with advanced
hepatocellular carcinoma

Chien-Fu Hung , Dong Liu , Tsung-Han Wu , Chao-Wei Lee , Kuang-Tse Pan , Ching-Ting Wang , Hsiu-Ying Chai ,
1
4
4
2*
1*
3
3
Ming-Chin Yu , Yi-Cheng Chen
2,3
5
1 Department of Radiology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Linkou Medical Center, Taoyuan 333, Taiwan.
2 Department of Surgery, Xiamen Chang Gung Hospital, Xiamen 361000, Fujian, China.
3 Department of Surgery, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Linkou Medical Center, Taoyuan 333, Taiwan.
4 Department of Nuring, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan 333, Taiwan.
5 Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan 333, Taiwan.
*Authors contributed equally to this study.
Correspondence to: Dr. Ming-Chin Yu, Department of Surgery, Chang Gung University and Memorial Hospital, No 5, Fu Hsing Street, Kuei Shan,
Taoyuan 333, Taiwan. E-mail: mingchin2000@gmail.com
How to cite this article: Hung CF, Liu D, Wu TH, Lee CW, Pan KT, Wang CT, Chai HY, Yu MC, Chen YC. Attenuation of liver stiffness in sorafenib-
treated patients with advanced hepatocellular carcinoma. Hepatoma Res 2017;3:52-7.
ABSTRACT
Article history: Aim: Sorafenib is a multi-tyrosine kinase inhibitor and the standard therapy for advanced
Received: 21-11-2016 hepatocellular carcinoma (HCC). This retrospective study aimed to observe the anti-fibrotic
Accepted: 08-02-2017 effect of sorafenib in patients with advanced HCC. Methods: Seventeen patients with
Published: 24-03-2017 advanced HCC were recruited. Shear wave velocity (SWV) using acoustic radiation force
impulse elastography and non-invasive serum markers for liver fibrosis, such as the aspartate
Key words: aminotransferase (AST) to alanine aminotransferase ratio (AAR), the AST to platelet ratio
Sorafenib, index, the fibrosis-4 index and the Lok index, were recorded at the beginning of sorafenib
liver stiffness, treatment and 3-6 months after sorafenib treatment in 2014-2015. Results: Nine (52.9%)
attenuation, patients achieved disease control status and 8 had progressive disease after a mean duration
advanced hepatocellular carcinoma of 11.1 months with sorafenib treatment. The mean SWV decreased from 2.37 m/s at the
beginning to 1.90 m/s after sorafenib treatment (P < 0.01). This trend was observed in patients
with and without liver cirrhosis (from 2.49 to 2.06 m/s, P = 0.06, and from 2.32 to 1.69 m/s,
P < 0.05, respectively). Among the non-invasive serum markers, no statistically significant
differences were observed except for the AAR in the cirrhotic group. Conclusion: Sorafenib
has potential antif-ibrotic effects in patients with advanced HCC.

INTRODUCTION Platelet-derived growth factor (PDGF) and vascular
endothelial growth factor (VEGF) are important for the
Liver fibrosis is a wound-healing response and a sustained activation and proliferation of hepatic stellate
common consequence of hepatic inflammation/injury cells (HSCs), which are activated and transformed into
caused by a variety of etiologies, such as infection, myofibroblasts during liver injury. [2,3] The treatment
drugs, metabolic disorders or immune attack. [1] of liver fibrosis by curing/controlling underlying liver
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