Page 223 - ebook HCC

EASL HCC SUMMITHCC SUMMIT
PROGRAMME
GENEV
220 PROGRAMME AND ABSTRACTSAND ABSTRACTS GENEVA, SWITZERLANDA, SWITZERLAND EASL 221
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220
FEBRUAR
FEBRUARY 13 - 16, 2014Y 13 - 16, 2014
Poster Board Number C16 Poster Board Number C17
SORAFENIB AFTER RFA IN HCC PATIENTS: SUBSEGMENTECTOMY TREATMENT FOR
A PILOT STUDY HEPATOCELLULAR CARCINOMA PATIENTS WITH
PORTAL HYPERTENSION

Giorgio De Stefano , Nunzia Farella , Valentina Iodice , Giulia Iorre ,
1
1
1
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Giosuè Calabria , Umberto Scognamiglio , Tiziana Ascione , Antonio Giorgio 1 Keming Zhang , Zhengyu Zhu 2
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1
1 Ultrasound Unit for Infectious Diseases, AORN dei Colli, Naples, Italy 1 Hepatobiliary Surgery Center, 302 Military Hospital of China, Beijing , Hepatobiliary
2
Surgery Center, 302 Military Hospital of China, Beijing, China
Corresponding author’s e-mail: lu.giacomelli6@gmail.com
Corresponding author’s e-mail: zhangkeming302@sina.cn
Introduction: This prospective study investigates the efficacy and safety of sorafenib after
radiofrequency ablation (RFA) in patients with hepatocellular carcinoma (HCC). Introduction: The role of clinically significant portal hypertension on the prognosis of
cirrhotic patients undergoing hepatic resection for hepatocellular carcinoma (HCC) is
Aims: Ninety-five HCC patients (67 males, 72.0±6.6 years) received sorafenib after debated.
RFA (n=44, 5 with intermediate and 39 with advanced HCC) or sorafenib only (n=51, 10
intermediate and 41 advanced). Patients received RFA either because they were not- Aims: In this study, our aim was to assess the therapeutic efficiency of subsegmentectomy
eligible to transcatheter arterial chemoembolization (intermediate HCC) or for debulking treatment HCC patients with portal hypertension
(advanced HCC). Time to progression (TTP), response rate (RR), duration of sorafenib Methodology: Between 2009 and 2013, we reviewed a total of 126 cirrhotic patients
treatment and adverse effects were evaluated. with PHT (defined by the presence of esophageal varices or a platelet count of <100,000/
microL in association with splenomegaly).underwent hepatectomy for single HCC. The
Results: Patients with large HCC were 20 (45.1%) in the RFA/sorafenib group and 23 patients were classified into the limited hepatic resection (n =84) and segmentectomy or
(45.1%) in the sorafenib group; patients with multifocal HCC were 24 (54.5%) and 28 subsegmentectomy (n=42) groups.
(54.9%), respectively. Nodules were 86 in the RFA/sorafenib group (median diameter
50mm) and 116 in the sorafenib group (51mm). Patients on RFA/sorafenib underwent a Results: Among Child-Pugh class A patients, both the 3-year overall survival and disease-
median of 2 RFA sessions. free survival rates in the segmentectomy or subsegmentectomy group were significantly
At a 12-month follow-up, TTP was longer with sorafenib/RFA (10.3±8.0 vs 7.2±6.7 months, better than those in the limited hepatic resection group (78% versus 56%, P=0.046, and
CLINICAL POSTER ABSTRACTS (10.9±8.0 vs 7.3±6.7 months, p=0.039). 18%, P=0.52). The morbidity rate reached no statistical significance in two groups among CLINICAL POSTER ABSTRACTS
p=0.04). RR was 61% with RFA/sorafenib and 40% with sorafenib (p<0.001; 2 vs 1
44% versus 26%, P=0.038, respectively). In Child-Pugh class B patients, the 3-year
complete responses). Duration of sorafenib therapy was also longer with RFA/sorafenib
overall survival analysis did not show significant differences in two groups (32% versus
Hand-foot skin reaction was observed in 4 patients on RFA/sorafenib and in 8 patients on
Child-Pugh class A /B(34% vs 31%,P = 0.56).
sorafenib, erythema in 4 versus 10 patients, and diarrhoea in 7 versus 19.
Conclusions: PHT should not be considered an absolute contraindication to a hepatectomy
Conclusions: Sorafenib after RFA resulted in a higher TTP and RR than sorafenib alone,
an option for Child-Pugh class A patients with PHT
and no new safety concerns were reported. These findings support a sequential treatment
with RFA and sorafenib in HCC patients. in cirrhotic patients. Segmentectomy and subsegmentectomy, for early-stage tumours is