Abstract | BACKGROUND: METHODS: HCC patients treated with sorafenib between 05/2006 and 03/2020 at the Medical University of Vienna were retrospectively analyzed. ABT was defined as antibiotic use within 30 days prior to or after sorafenib initiation. RESULTS: Of 206 patients, the majority was male (n=171, 83%) with a mean age of 66±9.6 years. Half of patients (n=94, 46%) had impaired liver function (Child-Pugh stage B). Median time of follow-up was 10.8 (95% CI: 9.2-12.3) months. ABT was administered in 23 (11%) patients due to different types of proven or clinically suspected bacterial infections (n=17, 74%) and hepatic encephalopathy (n=6, 26%). The median duration of ABT was 14 (IQR: 12-30) days. Penicillin (n=13, 57%), followed by rifaximin (n=6, 26%), fluoroquinolones (n=3, 13%), and cephalosporins (n=1, 4%), was administered in the ABT group. The ABT group had a significantly shorter median OS (4.7 (95% CI: 3.2-6.1) months vs 11.4 (95% CI: 9.9-12.9) months, p=0.012), which was confirmed in multivariable analysis (HR: 1.91 (95% CI: 1.1-3.2), p=0.014). Similarly, PFS trended to be shorter in the ABT group (3.5 (95% CI: 1.6-5.4) months vs 4.8 (95% CI: 3.9-5.7) months, p=0.099). None of the 10 patients with complete or partial response was found in the ABT group. CONCLUSION: ABT was independently associated with worse outcomes in sorafenib-treated HCC patients. Prospective studies are needed to elucidate the underlying mechanism.
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Authors | Katharina Pomej, Lorenz Balcar, Bernhard Scheiner, Georg Semmler, Tobias Meischl, Mattias Mandorfer, Thomas Reiberger, Christian Müller, Michael Trauner, Matthias Pinter |
Journal | Journal of hepatocellular carcinoma
(J Hepatocell Carcinoma)
Vol. 8
Pg. 1485-1493
( 2021)
ISSN: 2253-5969 [Print] New Zealand |
PMID | 34877268
(Publication Type: Journal Article)
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Copyright | © 2021 Pomej et al. |