Prognostic impact of metastatic site in patients receiving first-line sorafenib therapy for advanced hepatocellular carcinoma. (March 2023)

• Record Type: Journal Article
• Authors: Ielasi, L.; Tovoli, F.; Stefanini, B.; Tortora, R.; Magini, G.; Sacco, R.; Pressiani, T.; Trevisani, F.; Piscaglia, F.; Granito, A.
• Is Part Of: Digestive and liver disease. Volume 55(2023)Supplement 1
• Page Start: S42
• Publication Date: 2023-03
• Subjects: Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; 616.33005
• DOI: 10.1016/j.dld.2023.01.082
• Languages: English
• ISSNs: 1590-8658

Abstract

Abstract : Extrahepatic spread is a well-known negative prognostic factor in patients with advanced hepatocellular carcinoma (HCC). The prognostic role of different metastatic sites and their response rate to systemic treatment is still being debated. We considered 237 metastatic HCC patients treated with sorafenib as first-line therapy in five different Italian centers from 2010 to 2020. The most common metastatic sites were lymph nodes, lungs, bone and adrenal glands. In survival analysis, the presence of dissemination to lymph nodes (OS 7.1 vs 10.2 months; p = 0.007) and lungs (OS 5.9 vs 10.2 months; p <0.001) were significantly related to a worse survival. In the subgroup analysis of patients with a single metastatic site, this prognostic relationship remained statistically significant. Palliative radiation therapy on bone metastases significantly prolonged the survival in this cohort of patients (OS 19.4 vs 6.5 months; p <0.001). Furthermore, patients with lymph node and lung metastases had a worse disease control rate (39.4% and 30.5%, respectively) and a shorter radiological progression-free survival (3.4 and 3.1 months, respectively). Different site of metastases has a prognostic impact on survival; in particular, lymph node and lung metastases have worse prognosis and treatment response rate.