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Sorafenib Combined with Transarterial Chemoembolization versus Transarterial Chemoembolization Alone for Advanced-Stage Hepatocellular Carcinoma: A Propensity Score Matching Study

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  • Hao Hu
  • Zhenhua Duan
  • Xiaoran Long
  • Yancu Hertzanu
  • Haibin Shi
  • Sheng Liu
  • Zhengqiang Yang

Abstract

Aims: The purpose of the present study was to compare the efficacies of transarterial chemoembolization (TACE) combined with sorafenib versus TACE monotherapy for treating patients with advanced hepatocellular carcinoma (HCC). Methods: We enrolled 321 patients and selected 280 with advanced HCC (Barcelona Clinic Liver Cancer stage C) who underwent TACE therapy between February 2009 and February 2013. TACE alone (monotherapy group) was administered to 198 patients (70.7%), and the remaining 82 (29.3%) underwent repeat combined TACE and sorafenib therapy (combined group). To minimize selection bias, these latter 82 patients were matched using propensity-score matching at a 1∶2 ratio with 164 patients who received TACE monotherapy. The primary endpoints were overall survival (OS) and related subgroup analysis. The secondary endpoints were time to progression (TTP) and treatment-related adverse events. Results: Of the respective patients in the combined and monotherapy groups, 64.6% and 49.2% had vascular invasion, 87.8% and 91.1% had extrahepatic metastasis, and 54.3% and 47.1% had both. In the propensity-score–matched cohort, the OS survival of the combined group was significantly higher compared with the monotherapy group (7.0 months vs. 4.9 months, respectively, P = 0.003). The TTP was significantly longer in the combined group (2.6 months vs. 1.9 months, respectively, P = 0.001). Subgroup analysis showed that the outcomes of patients with advanced HCC without main portal vein invasion who were treated with combined therapy were significantly better compared with those who received monotherapy (P

Suggested Citation

  • Hao Hu & Zhenhua Duan & Xiaoran Long & Yancu Hertzanu & Haibin Shi & Sheng Liu & Zhengqiang Yang, 2014. "Sorafenib Combined with Transarterial Chemoembolization versus Transarterial Chemoembolization Alone for Advanced-Stage Hepatocellular Carcinoma: A Propensity Score Matching Study," PLOS ONE, Public Library of Science, vol. 9(5), pages 1-10, May.
    • Handle: RePEc:plo:pone00:0096620
    DOI: 10.1371/journal.pone.0096620
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    References listed on IDEAS

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    1. Sangheun Lee & Beom Kyung Kim & Seung Up Kim & Yehyun Park & Sooyun Chang & Jun Yong Park & Do Young Kim & Sang Hoon Ahn & Chae Yoon Chon & Kwang-Hyub Han, 2013. "Efficacy of Sorafenib Monotherapy versus Sorafenib-Based Loco-Regional Treatments in Advanced Hepatocellular Carcinoma," PLOS ONE, Public Library of Science, vol. 8(10), pages 1-1, October.
    2. Mingheng Liao & Jiwei Huang & Tao Zhang & Hong Wu, 2013. "Transarterial Chemoembolization in Combination with Local Therapies for Hepatocellular Carcinoma: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 8(7), pages 1-1, July.
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