Comparison of the efficacy of transcatheter arterial chemoembolization and sorafenib for advanced hepatocellular carcinoma

Abstract

The aim of the present study was to compare overall survival between stage IVA or stage IVB hepatocellular carcinoma (HCC) patients who received transcatheter arterial chemoembolization (TACE) and those who were treated with sorafenib. This retrospective comparative study included 55 patients with stage IVA or IVB HCC in whom TACE was performed as an initial treatment (the TACE group) and 56 patients with stage IVA or IVB HCC to whom sorafenib was administered (the sorafenib group). We compared the overall survival between these two groups. In the TACE group, there were 46 stage IVA HCC patients and 9 stage IVB HCC patients. In the sorafenib group, there were 26 stage IVA HCC patients and 30 stage IVB HCC patients. Median overall survival times were 6.6 months in the TACE group and 9.2 months in the sorafenib group. The 1- and 2-year overall survival rates were 34.4 and 14.2%, respectively, in the TACE group and 34.0 and 6.7%, respectively, in the sorafenib group. In terms of overall survival, there was no significant difference between the two groups (P=0.814). In subgroup analyses, according to HCC stage [stage IVA (P=0.266) or stage IVB (P=0.183)] and Child-Pugh classification [Child-Pugh A (P=0.915) or Child-Pugh B (P=0.676)], there were also no significant differences between the two groups. In conclusion, our study results suggest that TACE could serve as a first-line treatment for stage IV HCC patients as well as sorafenib therapy.

Figure 1

Cumulative overall survival between the transcatheter arterial chemoembolization (TACE) group and the sorafenib group. The 1- and 2-year overall survival rates were 34.4 and 14.2%, respectively, in the TACE group and 34.0 and 6.7%, respectively, in the sorafenib group. In terms of overall survival, there was no significant difference between the two groups (P=0.814).

Figure 2

Cumulative overall survival between the transcatheter arterial chemoembolization (TACE) group patients with stage IVA hepatocellular carcinoma (HCC) (n=46) and the sorafenib group patients with stage IVA HCC (n=26). The 1-year overall survival rates were 30.6% in the TACE group and 32.8% in the sorafenib group, respectively. In terms of overall survival, there was no significant difference between the two groups (P=0.266).

Figure 3

Cumulative overall survival between the transcatheter arterial chemoembolization (TACE) group patients with stage IVB hepatocellular carcinoma (HCC) (n=9) and the sorafenib group patients with stage IVA HCC (n=30). The 1-year overall survival rates were 43.5% in the TACE group and 30.2% in the sorafenib group. In terms of overall survival, there was no significant difference between the two groups (P=0.183).

Figure 4

Cumulative overall survival between the transcatheter arterial chemo embolization (TACE) group patients with Child-Pugh A (n=35) and the sorafenib group patients with Child-Pugh A (n=42). The 1-year overall survival rates were 41.1% in the TACE group and 30.4% in the sorafenib group. In terms of overall survival, there was no significant difference between the two groups (P=0.915).

Figure 5

Cumulative overall survival between the transcatheter arterial chemoembolization (TACE) group patients with Child-Pugh B (n=20) and the sorafenib group patients with Child-Pugh A (n=14). The 1-year overall survival rates were 20.0% in the TACE group and 21.4% in the sorafenib group, respectively. In terms of overall survival, there was no significant difference between the two groups (P=0.676).