Transarterial Chemoembolization within First 3 Months of Sorafenib Initiation Improves Overall Survival in Hepatocellular Carcinoma: A Retrospective, Multi-Institutional Study with Propensity Matching

Journal of Vascular and Interventional Radiology : JVIR
David E KaplanTamar H Taddei

Abstract

The impact of transarterial chemoembolization after initiation of sorafenib (SOR) has not been prospectively compared with SOR alone in unresectable hepatocellular carcinoma (HCC). The objective of this study was to assess whether SOR + transarterial chemoembolization provides benefit over SOR alone in this setting. A retrospective cohort study with propensity matching using data from patients prescribed SOR for HCC at Veterans Health Administration hospitals from 2007 to 2015. The primary outcome was overall survival from the time of SOR prescription and stratified by receipt of transarterial chemoembolization within 90 days of SOR initiation. A total of 4,896 patients received SOR for HCC, of whom 232 (4.7%) underwent transarterial chemoembolization within 90 days. Patients receiving transarterial chemoembolization + SOR were highly selected, being younger and with less significant hepatic dysfunction, earlier Barcelona Clinic Liver Cancer stage (P < .0001), and fewer tumors with lower rates of macrovascular invasion (MVI) and metastases (all P < .0001) than SOR-alone patients. In unadjusted analysis, SOR + transarterial chemoembolization was associated with reduced mortality (hazard ratio [HR] 0.61, 95% confidence interval [...Continue Reading

Citations

Jul 12, 2020·Journal of Gastroenterology and Hepatology·Anxin ChenMingyu Chen
Feb 18, 2020·Journal of Cellular Biochemistry·Xiaofeng NiHongwei Sun
Aug 23, 2019·World Journal of Gastrointestinal Oncology·Che-Yu HsuSung-Hsin Kuo
Jan 20, 2020·Journal of Hepatology·Daniel H PalmerLaura M Kulik

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