Sorafenib is currently the first-line
therapy for advanced
hepatocellular carcinoma (aHCC) patients. However, the outcomes and prognostic factors of
sorafenib therapy have not been well investigated. We aimed to investigate the pretreatment factors and outcomes among Taiwanese aHCC patients receiving
sorafenib treatment. A total of 347 patients with aHCC and well-compensated
liver cirrhosis (Child-Pugh A) status receiving
sorafenib were consecutively enrolled from March 2013 through December 2016. Pre-treatment clinical data and viral
hepatitis markers were collected and analyzed with their outcomes. The primary endpoint of the study was overall survival. The factors associated with overall survival were also investigated. The median overall survival of all the patients was 238 days (range, 9-1504 days) with a 1-year overall survival of 43.2%. Positive
hepatitis B surface antigen and absence of portal vein
thrombosis (PVT) were independent factors associated with better overall survival. The median duration of
sorafenib therapy was 93.0 days (range, 4-1504 days). After stopping
sorafenib, the median survival was 93.0 days (range, 1-1254 days). The 1-year survival after stopping
sorafenib was 21.2%. In
chronic hepatitis B patients, total
bilirubin level was the only factor associated with overall survival.
Hepatitis C antibody
RNA negativity,
tumor size, PVT, and white blood cell count were the independent factors associated with survival among those
chronic hepatitis C patients. There were different prognostic factors stratified by viral etiologies in aHCC patients receiving
sorafenib. Viral eradication increased survival in
chronic hepatitis C patients.