Evaluation of sorafenib treatment and hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma: a comparative study using the propensity score matching method

Abstract

While sorafenib (SFN) is the established worldwide standard therapeutic agent for advanced hepatocellular carcinoma (HCC), hepatic arterial infusion chemotherapy (HAIC) is also considered a favorable treatment for some advanced HCCs. This study aimed to evaluate each treatment and provide an optimal therapeutic choice for advanced HCCs. We analyzed 72 patients treated with SFN and 128 patients receiving HAIC. Both treatment groups were analyzed for prognostic and disease progression factors, and matched pair analysis was performed using the propensity score matching method. The preferable status of intrahepatic lesions, that is, no lesions or only a single (<3 cm) intrahepetic lesion, was positively associated with good prognosis and negatively associated with disease progression in the SFN group. Maximum tumor size (>5 cm) and low albumin (≤3.4 g/dL) were poor prognostic and disease progression factors in the HAIC group. Analysis of 53 patients selected from each of the SFN and HAIC groups based on the propensity score matching method showed no significant differences in survival or disease progression between the two matched subgroups. On the other hand, progression-free survival (PFS) in the HAIC-matched subgroup was significantly longer than in the SFN-matched subgroup, particularly in patients with portal vein invasion (PVI) and/or without extrahepatic spread (EHS). The treatment efficacy of HAIC is similar to that of SFN regarding survival and disease progression. Longer PFS might be expected for HAIC compared with SFN, particularly in patients with PVI and/or without EHS.

Transcatheter hepatic arterial infusion chemotherapy vs sorafenib in the treatment of patients with hepatocellular carcinoma of Barcelona Clinic Liver Cancer stage C: a meta-analysis of Asian population

“… 8 , 12 – 14 However, some other studies had reported conflicting results. 10 , 11 , 15 Meta-analysis is a method that combines data from all eligible studies, and has the advantages of reducing random error, obtaining more precise estimates, and defining the effect of clinical interventions more precisely. 18 , 19 Hence, meta-analysis is an eligible method to resolve such conflicts.…”

Treatment strategies for advanced hepatocellular carcinoma: Sorafenib vs hepatic arterial infusion chemotherapy

“…In a retrospective cohort study, while there was no significant difference in survival between the sorafenib group and the HAIC group, survival was significantly better in the HAIC group than in the sorafenib group among patients with macroscopic vascular invasion (14 mo vs 7 mo, P = 0.005)[ 72 ]. A propensity score matched analysis also showed no significant differences in survival or disease progression between the two groups, while PFS was significantly longer in the HAIC group than in the sorafenib group, particularly for patients with portal vein invasion and/or without extrahepatic spread[ 73 ]. On the other hand, survival was favorable in patients with HCC refractory to TACE treated with sorafenib rather than HAIC[ 74 ].…”

Hepatocellular Carcinoma with Macrovascular Invasion: Defining the Optimal Treatment Strategy

“…HAIC was implemented using two regimens: 102 patients were treated by the low-dose cisplatin + 5-fluorouracil regimen, and 26 were treated by the subcutaneous IFN-α + 5-fluorouracil regimen of HAIC. Analysis of 53 patients selected from each of the sorafenib and HAIC groups based on the propensity score-matching method showed no significant differences in survival ( p = 0.750) [27]. Shiozawa et al [28] compared sorafenib versus HAIC with cisplatin and 5-fluorouracil for in 80 patients with advanced HCC.…”

“…In addition, two studies compared HAIC and sorafenib in patients with advanced HCC using propensity score matching. Fukubayashi et al [27] analyzed 72 patients treated with sorafenib and 128 patients receiving HAIC. In this study, more than 50% of the patients had vascular invasion.…”