Sorafenib improves lipiodol deposition in transarterial chemoembolization of Chinese patients with hepatocellular carcinoma: a long-term, retrospective study

Abstract

ObjectiveThough synergy of sorafenib and transarterial chemoembolization (TACE) in hepatocellular carcinoma (HCC) is well discussed in previous reports, association of lipiodol retention by sorafenib addition to TACE with the survival outcomes remain elusive. Therefore, we studied the impact of sorafenib addition to TACE on survival outcomes mediated by lipiodol retention.Materials and MethodsThis is a long-term, retrospective, single-center study using medical records of patients diagnosed with HCC at the Department of Interventional Radiology of Zhengzhou University Affiliated Cancer Hospital (China) between April 2004 and March 2012.ResultsLipiodol deposition of > 50% was significantly increased in TACE + sorafenib group (70.87%) compared to TACE alone group (45.11%) (P = 0.0001). Significant increase in lipiodol deposition with sorafenib treatment was observed compared to TACE alone group (OR = 0.449, P = 0.041). The median overall survival in TACE + sorafenib and TACE alone groups were 38 months [95% CI = 9.772–56.228] and 31 months [95% CI = 21.855–40.145] respectively. Also, the hazard of death was comparatively greater in TACE alone group than TACE + sorafenib group [HR = 1.071]. Response rate to the therapy significantly increased after sorafenib administration to TACE patients, [compared to TACE alone treatment [69/103 (66.99%)] vs 55/133 (41.35%)], P = 0.0001.ConclusionsLipiodol deposition is significantly increased upon sorafenib addition after TACE. However, there was no significant impact of lipiodol deposition on the survival benefits exerted by the synergistic combination and hence, future prospective trails are warranted to validate the findings of this study.

Sorafenib with Transarterial Chemoembolization Achieves Improved Survival vs. Sorafenib Alone in Advanced Hepatocellular Carcinoma: A Nationwide Population-Based Cohort Study

“…A prospective clinical study has identified that TACE treatment may result in increased serum vascular endothelial growth factor levels one to two days following the procedure, which could increase the chance of extrahepatic spread and unfavorable outcomes [25,26]. Previous studies have also suggested that sorafenib treatment may improve lipiodol retention in HCC [19]. The latter provides support of better local control of aHCC, which may improve the survival, even in a patient with extrahepatic metastatic disease.…”

“…The rationale for incorporating TACE during sorafenib treatment results from the clinical observation that lipiodol deposition is significantly increased when sorafenib is added after TACE [19]. Certain local tumors can be controlled with TACE, thus preventing local disease progression.…”

Copy number profiling of circulating free DNA predicts transarterial chemoembolization response in advanced hepatocellular carcinoma

“…Previous studies have demonstrated that lipiodol deposition in HCC tumour might be used as an imaging indicator to evaluate TACE therapeutic efficacy [21][22][23][24]. By identifying the lipiodol deposition patterns on post-TACE CT, we first calculated the proportion of lipiodol deposition in all enrolled patients and categorized them into two different groups with 50% as cut-off according to previous reports [25][26][27] (Fig. 5A).…”

Effects of TACE combined with sorafenib on survival of patients with hepatocellular carcinoma based on ALBI grades and tumor load layers And Establishment of prognosis prediction model

“…In theory, the combination of TACE and anti angiogenesis drugs is effective and feasible. The theory of potential synergistic effect of targeted drugs combined with TACE is still developing, especially at the molecular level [23,24,25,26,27]. Child Pugh grades were different (P=0.038).…”