Effect of sorafenib combined with transcatheter arterial chemoembolization and radiofrequency ablation on the survival of patients with hepatocellular carcinoma

Objective To analyze the effect of sorafenib combined with transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA) on the survival of patients with hepatocellular carcinoma (HCC) and its prognostic factors.Methods A retrospective analysis was performed on 221 HCC patients who received sorafenib alone (group A) , sorafenib plus TACE (group B) , or sorafenib combined with TACE and RFA (group C) in Beijing YouAn Hospital, Capital Medical University, from January 2012 to June 2016 to investigate their median survival and its prognostic factors.The Kaplan-Meier method was used to plot a survival curve, and the log-rank test was used to test whether there was any difference in the survival curve;the Cox proportional-hazards regression model was used to analyze the influencing factors for survival rate;the Wilcoxon rank sum test was used to compare Child-Pugh class and Barcelona Clinic Liver Cancer (BCLC) stage between the patients treated with different therapies.Results Group C had a significantly longer median survival than group B (9.5 months vs 4.3 months, χ2=12.77, P=0.000 4) and group A (9.5 months vs 2.0 months, χ2=16.69, P<0.000 1) .The risk factors for disease progression were age<60 years, BCLC stage C, Child-Pugh class B, Child-Pugh class C, serum alpha-fetoprotein>200 ng/ml, poor tumor differentiation, tumor diameter>5 cm, and intrahepatic tumor with microvascular invasion or extrahepatic spread, as well as absence of sorafenib-related side events (all P<0.05) .Conclusion Sorafenib combined with TACE and RFA can prolong the survival of HCC patients.Age<60 years and severe tumor burden are poor prognostic factors for disease progression in HCC patients.