A comparison of the therapeutic efficacy of transarterial chemoembolization and combination therapy with transarterial chemoembolization plus sorafenib for unresectable hepatocellular carcinoma

Background and Aims] The combination therapy of transarterial chemoembolization (TACE) plus sorafenib has been applied for unresectable hepatocellular carcinoma (HCC). However, its efficacy remains controversial, possibly due to the timing of the initiation of sorafenib treatment. We evaluated the efficacy of this combination therapy when sorafenib treatment was initiated soon after the patient recovered from the adverse events due to the initial TACE procedure. [Methods] This was a retrospective study at a single hospital. Twenty-three unresectable HCC cases who exceeded the up-to-seven criteria but who showed no major vascular invasion or extrahepatic metastasis were enrolled in this study. The patients were classified into two groups : Group C (n=7) received combination therapy ; Group T (n=16) received TACE as the sole therapy. The time-to-tumor progression (TTP) and overall survival (OS) of the two groups were compared. [Results] The median TTP in Groups C and T was 1,737 days and 422 days, respectively (p < 0.05). The median survival time (MST) after the initiation of each therapy in Groups C and T was 1,780 days and 371 days, respectively (p < 0.05). [Conclusion] The TTP and OS of patients with unresectable HCC who received TACE plus sorafenib (administered soon after the initial TACE procedure) were superior to those in patients who received TACE alone.