Sorafenib extends the survival time of patients with multiple recurrences of hepatocellular carcinoma after liver transplantation

Aim： To determine the efficacy and toxicities of sorafenib in the treatment of patients with multiple recurrences of hepatocellular carcinoma （HCC） after liver transplantation in a Chinese population. Methods： Twenty patients with multiple recurrences of HCC after liver transplantation were retrospectively studied. They received either transarterial chemoembolization （TACE） or TACE combined with sorafenib. Results： The median survival times （MST） after multiple recurrences was 14 months （TACE＋sorafenib group） and 6 months （TACE only group）. The difference was significant in MST between the two groups （P=0.005）. The TACE ＋ sorafenib group had more stable disease （SD） patients than the TACE group. The most frequent adverse events of sorafenib were hand-foot skin reaction and diarrhea. In the univariate analysis, preoperative bilirubin and CHILD grade are found to be significantly associated with tumor-free survival time, the survival time after multiple recurrences and overall survival time. TACE＋sorafenib group showed a better outcome than single TACE treatment group. In the multivariate COX regression modeling, the preoperative high CHILD grade was found to be a risk factor of tumor-free survival time. In addition, the preoperative high bilirubin grade was also found to be a risk factor of survival time after recurrence and overall survival time. Furthermore, survival time after recurrence and overall survival time were also associated with therapeutic schedule, which was indicated by the GROUP. Conclusion： Treatment with TACE and sorafenib is worthy of further study and may have more extensive application prospects.