Ontology highlight
ABSTRACT: Background
Sorafenib has been established as the standard of care for patients with advanced hepatocellular carcinoma (HCC) since 2007 on the basis of two landmark trials (SHARP and Asia-Pacific). Ten years have passed since then and, despite much research in the field, still no validated real-life prognostic markers are available for HCC patients treated with this drug. Therefore, going through 10 years of research into sorafenib of several Italian Cancer Centers, we conducted a field-practice study aimed at identifying baseline clinical factors that could be significantly associated with overall survival (OS).Method
Univariate/multivariate analyses were conducted to retrospectively identify the impact of baseline characteristics on the OS of 398 advanced HCC patients treated with sorafenib.Results
Based on univariate analysis, α-fetoprotein (AFP), albumin, AST, bilirubin, Child-Pugh, ECOG, systemic immune-inflammation index (SII), albumin-bilirubin (ALBI) grade, and portal vein thrombosis were significantly associated with shorter OS. Following adjustment for clinical covariates positive in univariate analysis, the multivariate analysis including AFP, age, etiology, albumin, aspartate transaminase (AST), bilirubin, Child-Pugh, LDH, platelet-to-lymphocyte ratio, ECOG, ALBI grade, portal vein thrombosis, SII, and BCLC stage identified increase in LDH, age >70 years, no viral etiologies, ECOG >0, albumin <35, ALBI grade 2, and AST >40 as prognostic factors for poorer OS based on the 5% significance level.Conclusion
Our study highlights that baseline hepatic function, patient-centered variables, and etiology have prognostic value. These findings might have implications in terms of therapeutic decision-making and patient counseling.
SUBMITTER: Rovesti G
PROVIDER: S-EPMC6873043 | biostudies-literature | 2019 Oct
REPOSITORIES: biostudies-literature
Rovesti Giulia G Orsi Giulia G Kalliopi Andrikou A Vivaldi Caterina C Marisi Giorgia G Faloppi Luca L Foschi Francesco Giuseppe FG Silvestris Nicola N Pecora Irene I Aprile Giuseppe G Molinaro Eleonora E Riggi Laura L Ulivi Paola P Canale Matteo M Cucchetti Alessandro A Tamburini Emiliano E Ercolani Giorgio G Fornaro Lorenzo L Andreone Pietro P Zavattari Patrizia P Scartozzi Mario M Cascinu Stefano S Casadei-Gardini Andrea A
Gastrointestinal tumors 20190912 3-4
<h4>Background</h4>Sorafenib has been established as the standard of care for patients with advanced hepatocellular carcinoma (HCC) since 2007 on the basis of two landmark trials (SHARP and Asia-Pacific). Ten years have passed since then and, despite much research in the field, still no validated real-life prognostic markers are available for HCC patients treated with this drug. Therefore, going through 10 years of research into sorafenib of several Italian Cancer Centers, we conducted a field-p ...[more]