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©2013 Baishideng Publishing Group Co.
World J Hepatol. Jul 27, 2013; 5(7): 364-371
Published online Jul 27, 2013. doi: 10.4254/wjh.v5.i7.364
Published online Jul 27, 2013. doi: 10.4254/wjh.v5.i7.364
Table 1 Child-Turcotte-Pugh scoring system and classification for patients with chronic liver disease
Measures | 1 point | 2 points | 3 points |
Serum total bilirubin (mg/dL) | ≤ 2 | 2-3 | > 3 |
Serum albumin (g/dL) | > 3.5 | 2.8-3.5 | < 2.8 |
INR | < 1.7 | 1.71-2.30 | > 2.30 |
Ascites | None | Mild | Moderate to severe |
Hepatic encephalopathy | None | Grade I-II (or suppressed with medication) | Grade III- IV (or refractory) |
CTP points | CTP class | One year predicted survival | |
5-6 | A | 100% | |
7-9 | B | 81% | |
10-15 | C | 45% |
Table 2 Barcelona Clinic Liver Cancer staging system for hepatocellular carcinoma
Stage of HCC | Tumor features | Child-Pugh classification | Performance status test | Treatment |
Stage 0 | Single < 2 cm carcinoma in situ | Child-Pugh A | 0 | Resection |
Stage A | Single < 5 cm or 3 nodules < 3 cm | Child-Pugh A-B | 0 | Liver transplant, percutaneous ethanol injection, radiofrequency ablation |
Stage B | Single > 5 cm or multi-nodular | Child-Pugh A-B | 0 | TACE |
Stage C | Portal vein invasion | Child-Pugh A-B | 1-2 | Sorafenib |
Stage D | Distant metastasis | Child-Pugh A-B | 3-4 | Symptomatic |
Table 3 Comparison of demographic and disease characteristics of patients with hepatocellular carcinoma in both treatment groups
Characteristic | TACE + sorafenib(n = 13) | TACE alone(n = 30) | P value |
Age (yr) | 61.4 ± 7.5 | 59.2 ± 7.4 | 0.39 |
Etiology | 0.18 | ||
Alcohol | 2 (15.4) | 1 (3.4) | |
Hepatitis C | 6 (46.1) | 17 (56.6) | |
Hepatitis C and alcohol | 3 (23.1) | 11 (36.6) | |
Non-alcohol/non-hepatitis C | 2 (15.4) | 1 (3.4) | |
HCC histology | 0.86 | ||
Poorly differentiated | 1 (7.6) | 3 (10.0) | |
Moderately differentiated | 7 (53.8) | 13 (43.3) | |
Well differentiated | 5 (38.6) | 14 (46.7) | |
CTP classification | 0.69 | ||
A | 11 | 23 | |
B | 2 | 7 | |
BCLC staging for HCC | 0.004 | ||
A | 6 | 22 | |
B | 2 | 8 | |
C | 5 | 0 | |
BCLC staging for HCC (excluding stage C) | 0.98 | ||
A | 6 | 22 | |
B | 2 | 8 | |
MELD score | 8.8 ± 2.3 | 9.8 ± 2.9 | 0.29 |
AFP (ng/mL) | 6.6 (2.3-745) | 8.1 (1.9-6000) | 0.96 |
Tumor size seen on CT with the largest diameter (cm) | 4 (1.5 -16.7) | 3.1 (1.4 -5.8) | 0.58 |
Table 4 Statistical analysis for each covariate in univariate cox regression model predicting overall survival
Characteristic | HR (95%CI) | P value |
Age (yr) | 0.99 (0.95-1.04) | 0.79 |
Etiology | 1.04 (0.66-1.63) | 0.86 |
Alcohol | ||
Hepatitis C | ||
Hepatitis C and alcohol | ||
Non-alcohol/non-hepatitis C | ||
HCC histology | 0.73 (0.43-1.25) | 0.26 |
Poorly differentiated | ||
Moderately differentiated | ||
Well differentiated | ||
CTP classification | 3.84 (1.74-8.51) | 0.001 |
A | ||
B | ||
BCLC staging for HCC | 1.58 (1.02-2.46) | 0.04 |
A | ||
B | ||
C | ||
BCLC staging for HCC (excluding stage C) | 1.5 (0.66-3.43) | 0.34 |
A | ||
B | ||
MELD score | 1.1 (0.98-1.23) | 0.08 |
AFP (ng/mL) | 0.99 (0.82-1.20) | 0.98 |
Tumor size seen on CT with the largest diameter (cm) | 1.06 (0.93-1.20) | 0.41 |
Table 5 Adverse events attributed to both treatment arms
Adverse events (CTCAE grades 1-3) | TACE alone | TACE + sorafenib | P value |
Hand foot skin reaction | 0 | 2 | 0.554 |
Diarrhea | 0 | 1 | |
Hypertension (mild) | 0 | 1 | |
Abdominal pain (mild) | 6 | 1 | |
Nausea, vomiting | 3 | 0 | |
Elevated liver enzymes (< 2 times of normal limits) | 1 | 2 |
- Citation: Muhammad A, Dhamija M, Vidyarthi G, Amodeo D, Boyd W, Miladinovic B, Kumar A. Comparative effectiveness of traditional chemoembolization with or without sorafenib for hepatocellular carcinoma. World J Hepatol 2013; 5(7): 364-371
- URL: https://www.wjgnet.com/1948-5182/full/v5/i7/364.htm
- DOI: https://dx.doi.org/10.4254/wjh.v5.i7.364