Hepatocellular carcinoma (HCC) is the most common primary liver cancer. The recurrence rate after hepatectomy remains high, which seriously affects the prognosis. Microvascular invasion (MVI) has been proved to be an independent risk factor for the recurrence of liver cancer. If patients with MVI can receive timely and effective treatment, it will help reduce the recurrence rate, and prolong the survival time. The aim of the study was to analyze the effect of sorafenib on the clinical outcomes in HCC patients with MVI after hepatectomy.
Patients with HCC who underwent hepatectomy and were pathologically diagnosed as MVI at the research center between January 2009 and December 2016 were retrospectively analyzed. Patients were divided into sorafenib group and control group according to whether or not sorafenib (Nexavar®) was taken after surgery. Sorafenib was administered orally, 0.4 g each time, twice daily. Follow-up was performed after hepatectomy. The recurrence-free survival (RFS) and overall survival (OS) were observed. Associated factors were analyzed using univariate and multivariate COX regression.
This study included 16 patients in the sorafenib group and 33 patients in the control group. There was no significant difference in age, gender, hepatitis B surface antigen level, preoperative prethrombin time (PT), BCLC stage, preoperative a-fetoprotein level, maximum tumor diameter, and tumor number (all P < 0.05). The RFS and OS were both longer in the sorafenib group (both P < 0.05). The three-year RFS rates of the sorafenib group and the control group were 9 (56.3%) and 8 (24.2%), respectively, with significant difference (P = 0.027). The three-year OS rates of the sorafenib and control group were 13 (81.3%) and 13 (39.4%), respectively, with significant differences (P = 0.006). The results of multivariate COX regression indicated that preoperative PT and sorafenib treatment were the independent associated factors for RFS and OS.
The use of sorafenib after hepatectomy in HCC patients with MVI can prolong survival time.
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