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Minoux K, Lassailly G, Ningarhari M, Lubret H, El Amrani M, Canva V, Truant S, Mathurin P, Louvet A, Lebuffe G, Goria O, Nguyen-Khac E, Boleslawski E, Dharancy S. Neo-Adjuvant Use of Sorafenib for Hepatocellular Carcinoma Awaiting Liver Transplantation. Transpl Int 2022; 35:10569. [PMID: 36438781 PMCID: PMC9681796 DOI: 10.3389/ti.2022.10569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 10/21/2022] [Indexed: 12/01/2023]
Abstract
Data on efficacy and safety of sorafenib in a neoadjuvant setting for HCC awaiting liver transplantation (LT) are heterogeneous and scarce. We aimed to investigate the trajectory of patients treated with sorafenib while awaiting LT. All patients listed for HCC and treated with sorafenib were included in a monocentric observational study. A clinical and biological evaluation was performed every month. Radiological tumor response evaluation was realized every 3 months on the waiting list and every 6 months after LT. Among 327 patients listed for HCC, 62 (19%) were treated with Sorafenib. Sorafenib was initiated for HCC progression after loco-regional therapy (LRT) in 50% of cases and for impossibility of LRT in 50% of cases. The mean duration of treatment was 6 months. Thirty six patients (58%) dropped-out for tumor progression and 26 (42%) patients were transplanted. The 5-year overall and recurrent-free survival after LT was 77% and 48% respectively. Patients treated for impossibility of LRT had acceptable 5-year intention-to-treat overall and post-LT survivals. Conversely, patients treated for HCC progression presented high dropout rate and low intention-to-treat survival. Our results suggest that it is very questionable in terms of utility that patients treated for HCC progression should even be kept listed once the tumor progression has been observed.
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Affiliation(s)
- Kate Minoux
- CHU Lille, Department of Hepatogastroenterology, Lille, France
- INSERM U995, University of Lille, Lille, France
| | - Guillaume Lassailly
- CHU Lille, Department of Hepatogastroenterology, Lille, France
- INSERM U995, University of Lille, Lille, France
| | - Massih Ningarhari
- CHU Lille, Department of Hepatogastroenterology, Lille, France
- INSERM U995, University of Lille, Lille, France
| | - Henri Lubret
- CHU Lille, Department of Hepatogastroenterology, Lille, France
- INSERM U995, University of Lille, Lille, France
| | - Medhi El Amrani
- CHU Lille, Department of Digestive Surgery and Transplantation, University of Lille, Lille, France
| | - Valérie Canva
- CHU Lille, Department of Hepatogastroenterology, Lille, France
- INSERM U995, University of Lille, Lille, France
| | - Stéphanie Truant
- CHU Lille, Department of Digestive Surgery and Transplantation, University of Lille, Lille, France
| | - Philippe Mathurin
- CHU Lille, Department of Hepatogastroenterology, Lille, France
- INSERM U995, University of Lille, Lille, France
| | - Alexandre Louvet
- CHU Lille, Department of Hepatogastroenterology, Lille, France
- INSERM U995, University of Lille, Lille, France
| | - Gilles Lebuffe
- CHU Lille, Department of Anesthesiology, Resuscitation, and Critical Care Anesthesiology, University of Lille, Lille, France
| | - Odile Goria
- CHU Rouen, Department of Hepatogastroenterology, Hôpital Charles Nicolle, Rouen, France
| | - Eric Nguyen-Khac
- CHU Amiens-Picardie, Hôpital Sud, Department of Hepatogastroenterology, Amiens, France
- CHU Amiens, Centre Universitaire de Recherche en Santé (CURS), Université de Picardie-Jules-Verne (UPJV), Groupe de Recherche sur l’alcool et les Pharmacodépendances (GRAP), Inserm U1247, Amiens, France
| | - Emmanuel Boleslawski
- CHU Lille, Department of Digestive Surgery and Transplantation, University of Lille, Lille, France
| | - Sebastien Dharancy
- CHU Lille, Department of Hepatogastroenterology, Lille, France
- INSERM U995, University of Lille, Lille, France
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