Radiotherapy and sorafenib in the management of patients with hepatocellular carcinoma have led to improved survival: A single center experience

Background & Aims: Hepatocellular Carcinoma (HCC) is the sixth most common malignancy andthe third most common cause of cancer mortality worldwide. We aimed to assess the effect of noveltreatment options on the survival of HCC patients.Methods: This retrospective study included all HCC patients diagnosed between 2000 and 2013referred to the Davidoff center and treated by a multidisciplinary team.Results: The analysis included 321 patients (median age, 64 years; 74.8% males; 74.1% viral carriers;76.0% cirrhosis; 56.7% diagnosis at an early stage). The estimated hazard ratio by multivariate analysisfor the effect of the period of diagnosis (2007-2013 vs. 2000-2006) on survival was 0.72 (95% CI:0.54-0.96; p=0.027). There was no difference in the distribution by CP score, by BCLC stage at diagnosisor in the proportion of patients undergoing surgical procedures (liver transplantation or resection). Inthe later time frame, there was a significant decrease in the proportion of patients undergoingpercutaneous treatments (14.6% vs.4.2%, p=0.004) and embolization (46.9% vs.24.6%, p=0.001), and asignificant increase in radiotherapy (1.5% vs. 8.4%, p=0.009) and treatment with sorafenib (6% vs. 18.3%,p=0.002).Conclusion: Technological/pharmaceutical innovations have led to advancement in HCC treatment.Since there was no significant difference in the proportion of patients undergoing surgical proceduresduring the evaluated timeframe, the improved survival may stem from better management of advancedstage patients by a multidisciplinary team.