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Article

High cholinesterase predicts tolerance to sorafenib treatment and improved prognosis in patients with transarterial chemoembolization refractory intermediate stage hepatocellular carcinoma

  • Authors:
    • Shintaro Takaki
    • Takayuki Fukuhara
    • Nami Mori
    • Keiji Tsuji
  • View Affiliations / Copyright

    Affiliations: Department of Gastroenterology, Hiroshima Red Cross Hospital and Atomic‑Bomb Survivors Hospital, Hiroshima 730‑8619, Japan
  • Pages: 60-68
    |
    Published online on: November 18, 2019
       https://doi.org/10.3892/mco.2019.1949
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Abstract

Although sorafenib is the standard treatment for patients with advanced hepatocellular carcinoma (HCC), the predictive factors sorafenib tolerance in intermediate‑stage HCC cannot be accurately determined. The aim of the current study was to identify the predictive characteristics for the continuation of sorafenib treatment (≥400 mg) in patients with transarterial chemoembolization (TACE)‑refractory intermediate HCC and to identify candidates for second‑line sorafenib treatment. A total of 33 TACE‑refractory intermediate patients with HCC that were treated with sorafenib, and who had reached progressive disease (PD), were analyzed in the present retrospective study. Of 33 patients, 6 patients (18.1%) were able to continue sorafenib treatment (≥400 mg) until PD, however, a total of 27 patients (71.9%) were unable to continue treatment (<400 mg). The current study compared the baseline characteristics parameters to sorafenib ≥400 mg and <400 mg using a logistic regression model. The overall survival (OS) of patients receiving sorafenib ≥400 mg treatment was significantly increased compared with patients receiving sorafenib treatment <400 mg [554.5 days (228‑674) vs. 219 days (134‑369); P=0.0315). A univariate analysis was performed and indicated that Age (<75 years; P=0.021), total cholesterol (>180 mg/dl; P=0.026) and cholinesterase (ChE; ≥220 U/l; P=0.024) were significant factors, and a multivariate analysis indicated that ChE (≥220 U/l) was a significant prognostic factor (HR: 11.9; 95% CI: 1.19‑118.0; P=0.004). Both progression‑free survival [279 (204‑403) vs. 117.5 (63‑197) days; P=0.0136] and OS [470 (277‑679) vs. 171.5 (80‑236) days; P=0.0004] were significantly increased in patients with ChE levels ≥220 U/l compared with patients exhibiting ChE levels <220 U/l. Baseline high value of ChE in intermediate‑stage HCC predicts the ability to continue sorafenib treatment at ≥400 mg.
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Copy and paste a formatted citation
Spandidos Publications style
Takaki S, Fukuhara T, Mori N and Tsuji K: High cholinesterase predicts tolerance to sorafenib treatment and improved prognosis in patients with transarterial chemoembolization refractory intermediate stage hepatocellular carcinoma. Mol Clin Oncol 12: 60-68, 2020.
APA
Takaki, S., Fukuhara, T., Mori, N., & Tsuji, K. (2020). High cholinesterase predicts tolerance to sorafenib treatment and improved prognosis in patients with transarterial chemoembolization refractory intermediate stage hepatocellular carcinoma. Molecular and Clinical Oncology, 12, 60-68. https://doi.org/10.3892/mco.2019.1949
MLA
Takaki, S., Fukuhara, T., Mori, N., Tsuji, K."High cholinesterase predicts tolerance to sorafenib treatment and improved prognosis in patients with transarterial chemoembolization refractory intermediate stage hepatocellular carcinoma". Molecular and Clinical Oncology 12.1 (2020): 60-68.
Chicago
Takaki, S., Fukuhara, T., Mori, N., Tsuji, K."High cholinesterase predicts tolerance to sorafenib treatment and improved prognosis in patients with transarterial chemoembolization refractory intermediate stage hepatocellular carcinoma". Molecular and Clinical Oncology 12, no. 1 (2020): 60-68. https://doi.org/10.3892/mco.2019.1949
Copy and paste a formatted citation
x
Spandidos Publications style
Takaki S, Fukuhara T, Mori N and Tsuji K: High cholinesterase predicts tolerance to sorafenib treatment and improved prognosis in patients with transarterial chemoembolization refractory intermediate stage hepatocellular carcinoma. Mol Clin Oncol 12: 60-68, 2020.
APA
Takaki, S., Fukuhara, T., Mori, N., & Tsuji, K. (2020). High cholinesterase predicts tolerance to sorafenib treatment and improved prognosis in patients with transarterial chemoembolization refractory intermediate stage hepatocellular carcinoma. Molecular and Clinical Oncology, 12, 60-68. https://doi.org/10.3892/mco.2019.1949
MLA
Takaki, S., Fukuhara, T., Mori, N., Tsuji, K."High cholinesterase predicts tolerance to sorafenib treatment and improved prognosis in patients with transarterial chemoembolization refractory intermediate stage hepatocellular carcinoma". Molecular and Clinical Oncology 12.1 (2020): 60-68.
Chicago
Takaki, S., Fukuhara, T., Mori, N., Tsuji, K."High cholinesterase predicts tolerance to sorafenib treatment and improved prognosis in patients with transarterial chemoembolization refractory intermediate stage hepatocellular carcinoma". Molecular and Clinical Oncology 12, no. 1 (2020): 60-68. https://doi.org/10.3892/mco.2019.1949
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