Clinical outcomes of sorafenib treatment in Child-Pugh B hepatocellular carcinoma patients: a retrospective single-center study

Yıl 2025, Cilt: 16 Sayı: 2, 271 - 275, 30.06.2025

Ömer Faruk Kuzu , Alper Topal , Esmanur Kaplan Tüzün , Hüseyin Atacan , Nuri Karadurmuş

https://doi.org/10.18663/tjcl.1641413

Öz

Aim: Hepatocellular carcinoma (HCC) is a leading cause of liver-related mortality, particularly in patients with cirrhosis. Sorafenib is one of the primary systemic therapies for advanced HCC. This study aimed to evaluate the clinical outcomes and prognostic factors associated with sorafenib treatment in this patient population.

Material and Methods: This retrospective, single-center study included 28 patients with Child-Pugh B HCC who were treated with sorafenib. Patient characteristics, overall survival (OS), and progression-free survival (PFS) were analyzed. Kaplan-Meier survival analysis and Cox regression were used to assess prognostic factors, including transarterial chemoembolization (TACE), transarterial radioembolization (TARE), and tumor size.

Results: Among the 28 patients, 85.7% were male and 89.3% had cirrhosis. Biopsy was performed in 64.3% of cases, and extrahepatic spread was observed in only 3.6%. Tumor size exceeded 5 cm in 67.9% of patients. Disease control was achieved in 57.1% with stable disease (SD), 10.7% showed partial response (PR), and 32.1% experienced progressive disease (PD). Median OS and PFS were 8.1 and 5.9 months, respectively. Cox regression analysis did not identify TACE, TARE, or tumor size as statistically significant prognostic factors.

Conclusion: Sorafenib led to disease stabilization in over half of the patients, although one-third experienced disease progression. Compared to the SHARP and Asia-Pacific trials, our study yielded different outcomes, likely due to the exclusive inclusion of patients with Child-Pugh B score of 7. These findings underscore the need for improved patient selection, potential combination therapies, and the identification of predictive biomarkers to enhance treatment efficacy.

Anahtar Kelimeler

Hepatocellular Carcinoma , Sorafenib , Child-B

Etik Beyan

This study was approved by Gülhane Training and Research Hospital Ethics Committee with protocol number 2024/506

Destekleyen Kurum

The authors received no financial support for the research and/or authorship of this article.

Child-Pugh B hepatoselüler karsinom hastalarında sorafenib tedavisinin klinik sonuçları ve prognostik faktörleri: retrospektif tek merkezli bir çalışma

Öz

Amaç: Hepatoselüler karsinom (HCC), özellikle sirozu bulunan hastalarda karaciğere bağlı mortalitenin başlıca nedenlerinden biridir. Sorafenib, ileri evre HCC tedavisinde kullanılan birincil sistemik ajanlardan biridir. Bu çalışma, Sorafenib tedavisi uygulanan hastalarda klinik sonuçları ve prognostik faktörleri değerlendirmeyi amaçlamaktadır.

Gereç ve Yöntemler: Bu retrospektif, tek merkezli çalışmaya, Sorafenib ile tedavi edilen 28 Child-Pugh B HCC hastası dahil edilmiştir. Hastaların demografik ve klinik özellikleri, genel sağkalım (OS) ve progresyonsuz sağkalım (PFS) değerlendirilmiştir. Kaplan-Meier sağkalım analizleri ve Cox regresyon testleri ile transarteryel kemoembolizasyon (TACE), transarteryel radyoembolizasyon (TARE) ve tümör boyutu gibi olası prognostik faktörler analiz edilmiştir.

Bulgular: Çalışmaya dahil edilen 28 hastanın %85,7’si erkek ve %89,3’ü sirozlu olup, %64,3’üne biyopsi yapılmıştır. Ekstrahepatik yayılım %3,6 oranında saptanmıştır. Hastaların %67,9’unda tümör boyutu 5 cm’nin üzerindedir. Sorafenib tedavisi sonrası hastaların %57,1’inde stabil hastalık (SD), %10,7’sinde kısmi yanıt (PR), %32,1’inde ise progresyon (PD) gözlenmiştir. Ortanca OS 8,1 ay, PFS ise 5,9 ay olarak hesaplanmıştır. Cox regresyon analizinde TACE, TARE ve tümör boyutunun sağkalım üzerinde anlamlı etkisi bulunmamıştır.

Sonuç: Sorafenib tedavisi, hastaların çoğunda hastalığın stabil seyretmesini sağlamış olmakla birlikte, önemli bir hasta grubunda progresyon gelişmiştir. Bu durum, hasta seçiminin daha dikkatli yapılması ve kombine tedavi stratejilerinin değerlendirilmesi gerektiğini göstermektedir. SHARP ve Asya-Pasifik çalışmalarıyla karşılaştırıldığında farklı sonuçlar elde edilmesinin nedeni, bu çalışmaya yalnızca Child-Pugh B (puan 7) hastalarının dahil edilmesidir. Bulgular, tedavi stratejilerinin optimize edilmesi ve prognostik biyobelirteçlerin belirlenmesinin önemini vurgulamaktadır.

Anahtar Kelimeler

hepatosellür kanser , sorafenib , child-b

Kaynakça

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