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Survival Benefit of Hepatic Arterial Infusion Chemotherapy over Sorafenib in the Treatment of Locally Progressed Hepatocellular Carcinoma

1
Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan
2
Iwamoto Internal Medicine Clinic, Kitakyusyu 802-0832, Japan
3
Department of Gastroenterology, Juntendo University, Bunkyo-ku 113-8421, Japan
4
Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka 589-8511, Japan
5
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Miki 761-0793, Japan
6
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan
7
Division of Gastroenterology, IMS Sapporo Digestive Disease Center General Hospital, Sapporo 063-0842, Japan
8
Division of Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Iwate 028-3695, Japan
9
Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama 790-0024, Japan
10
Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Fukuoka 811-1395, Japan
11
Department of Gastroenterology, Hachinohe Red Cross Hospital, Aomori 039-1104, Japan
12
Department of Gastroenterology, Osaka National Hospital, Osaka 540-0006, Japan
13
Department of Gastroenterology, Kagawa Rosai Hospital, Marugame 763-8502, Japan
14
Department of Gastroenterology, Maebashi Red Cross Hospital, Maebashi 371-0811, Japan
15
Division of Gastroenterology, Department of Medicine, Social Insurance Tagawa Hospital, Tagawa 826-0023, Japan
16
Department of Gastroenterology, Kurume General Hospital, Kurume 830-8521, Japan
17
Department of Gastroenterology, Tobata Kyoritsu Hospital, Kitakyusyu 804-0093, Japan
18
Department of Gastroenterology, Kurume University Medical Center, Kurume 839-0863, Japan
19
Department of Gastroenterology, Saga Central Hospital, Saga 849-8522, Japan
20
Department of Gastroenterology, Asakura Medical Association Hospital, Asakura 838-0069, Japan
21
Department of Gastroenterology, Chikugo City Hospital, Chikugo 833-0041, Japan
22
Department of Gastroenterology, Kurume Central Hospital, Kurume 830-0001, Japan
23
Department of Gastroenterology, National Hospital Organization Kyushu Medical Center, Fukuoka 810-8563, Japan
24
Department of Gastroenterology, St. Mary’s Hospital, Kurume 830-8543, Japan
25
Department of Gastroenterology, Omuta City Hospital, Omuta 836-0861, Japan
26
Department of Gastroenterology, Yokokura Hospital, Miyama 839-0215, Japan
27
Center for Comprehensive Community Medicine Faculty of Medicine, Saga University, Saga 840-0027, Japan
*
Authors to whom correspondence should be addressed.
New FP Study Group is provided in the Acknowledgement.
Kurume Liver Cancer Study Group of Japan is provided in the Acknowledgement.
Academic Editor: David Wong
Cancers 2021, 13(4), 646; https://doi.org/10.3390/cancers13040646
Received: 17 January 2021 / Revised: 30 January 2021 / Accepted: 2 February 2021 / Published: 5 February 2021
(This article belongs to the Special Issue Advances of Locoregional Therapy for Hepatocellular Carcinoma)
Not all patients with hepatocellular carcinoma (HCC) benefit from treatment with systemic treatments such as sorafenib. Hepatic arterial infusion chemotherapy (HAIC) is the treatment using an indwelling catheter port system. The regimen of HAIC used in the study is New FP which is consisted of a fine-powder cisplatin and 5-fluorouracil. In the study, for the patients with locally progressed HCC, such as HCC with vascular invasion, initial administration of local hepatic treatment using HAIC was superior to systemic treatment using sorafenib.
BACKROUND: Not all patients with hepatocellular carcinoma (HCC) benefit from treatment with molecular targeted agents such as sorafenib. We investigated whether New-FP (fine-powder cisplatin and 5-fluorouracil), a hepatic arterial infusion chemotherapy regimen, is more favorable than sorafenib as an initial treatment for locally progressed HCC. METHODS: To avoid selection bias, we corrected the data from different facilities that did or did not perform New-FP therapy. In total, 1709 consecutive patients with HCC initially treated with New-FP or sorafenib; 1624 (New-FP, n = 644; sorafenib n = 980) were assessed. After propensity score matching (PSM), overall survival (OS) and prognostic factors were assessed (n = 344 each). Additionally, the patients were categorized into four groups: cohort-1 [(without macrovascular invasion (MVI) and extrahepatic spread (EHS)], cohort-2 (with MVI), cohort-3 (with EHS), and cohort-4 (with MVI and EHS) to clarify the efficacy of each treatment. RESULTS: New-FP prolonged OS than sorafenib after PSM (New-FP, 12 months; sorafenib, 7.9 months; p < 0.001). Sorafenib treatment, and severe MVI and EHS were poor prognostic factors. In the subgroup analyses, the OS was significantly longer the New-FP group in cohort-2. CONCLUSIONS: Local treatment using New-FP is a potentially superior initial treatment compared with sorafenib as a multidisciplinary treatment in locally progressed HCC without EHS. View Full-Text
Keywords: hepatocellular carcinoma; intra-arterial infusions; sorafenib; molecular targeted therapy hepatocellular carcinoma; intra-arterial infusions; sorafenib; molecular targeted therapy
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MDPI and ACS Style

Iwamoto, H.; Niizeki, T.; Nagamatsu, H.; Ueshima, K.; Nomura, T.; Kuzuya, T.; Kasai, K.; Kooka, Y.; Hiraoka, A.; Sugimoto, R.; Yonezawa, T.; Ishihara, A.; Deguchi, A.; Arai, H.; Shimose, S.; Shirono, T.; Nakano, M.; Okamura, S.; Noda, Y.; Kamachi, N.; Sakai, M.; Suzuki, H.; Aino, H.; Matsukuma, N.; Matsugaki, S.; Ogata, K.; Yano, Y.; Ueno, T.; Kajiwara, M.; Itano, S.; Fukuizumi, K.; Kawano, H.; Noguchi, K.; Tanaka, M.; Yamaguchi, T.; Kuromatsu, R.; Kawaguchi, A.; Koga, H.; Torimura, T.; New FP Study Group; Kurume Liver Cancer Study Group of Japan. Survival Benefit of Hepatic Arterial Infusion Chemotherapy over Sorafenib in the Treatment of Locally Progressed Hepatocellular Carcinoma. Cancers 2021, 13, 646. https://doi.org/10.3390/cancers13040646

AMA Style

Iwamoto H, Niizeki T, Nagamatsu H, Ueshima K, Nomura T, Kuzuya T, Kasai K, Kooka Y, Hiraoka A, Sugimoto R, Yonezawa T, Ishihara A, Deguchi A, Arai H, Shimose S, Shirono T, Nakano M, Okamura S, Noda Y, Kamachi N, Sakai M, Suzuki H, Aino H, Matsukuma N, Matsugaki S, Ogata K, Yano Y, Ueno T, Kajiwara M, Itano S, Fukuizumi K, Kawano H, Noguchi K, Tanaka M, Yamaguchi T, Kuromatsu R, Kawaguchi A, Koga H, Torimura T, New FP Study Group, Kurume Liver Cancer Study Group of Japan. Survival Benefit of Hepatic Arterial Infusion Chemotherapy over Sorafenib in the Treatment of Locally Progressed Hepatocellular Carcinoma. Cancers. 2021; 13(4):646. https://doi.org/10.3390/cancers13040646

Chicago/Turabian Style

Iwamoto, Hideki; Niizeki, Takashi; Nagamatsu, Hiroaki; Ueshima, Kazuomi; Nomura, Takako; Kuzuya, Teiji; Kasai, Kazuhiro; Kooka, Yohei; Hiraoka, Atsushi; Sugimoto, Rie; Yonezawa, Takehiro; Ishihara, Akio; Deguchi, Akihiro; Arai, Hirotaka; Shimose, Shigeo; Shirono, Tomotake; Nakano, Masahito; Okamura, Shusuke; Noda, Yu; Kamachi, Naoki; Sakai, Miwa; Suzuki, Hiroyuki; Aino, Hajime; Matsukuma, Norito; Matsugaki, Satoru; Ogata, Kei; Yano, Yoichi; Ueno, Takato; Kajiwara, Masahiko; Itano, Satoshi; Fukuizumi, Kunitaka; Kawano, Hiroshi; Noguchi, Kazunori; Tanaka, Masatoshi; Yamaguchi, Taizo; Kuromatsu, Ryoko; Kawaguchi, Atsushi; Koga, Hironori; Torimura, Takuji; New FP Study Group; Kurume Liver Cancer Study Group of Japan. 2021. "Survival Benefit of Hepatic Arterial Infusion Chemotherapy over Sorafenib in the Treatment of Locally Progressed Hepatocellular Carcinoma" Cancers 13, no. 4: 646. https://doi.org/10.3390/cancers13040646

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