Long-term survivors after sorafenib therapy in unresectable hepatocellular carcinoma.

470 Background: Sorafenib is one of the standard therapies for unresectable HCC. Recently, so-called “conversion” cases, who had received curative resection after sorafenib therapy, have been reported sporadically. Here, we investigated outcome of sorafenib treatment and characteristics of long-term survivors. Methods: 1) Thirty-five patients with advanced HCC underwent sorafenib therapy were enrolled. 2) The data of 59 patients from main three hospitals in Tokushima were reviewed to study the characteristics of long-term survivors. Results: 1.) The median treatment period was 3.7mo. The 1-year survival rate was 58%. The rate of partial response was 9% and the rate of stable disease was 34%. These two patients were converted to the surgical resection after sorafenib therapy. Conversion case: 50-year old male with huge unresectable HCC underwent sorafenib therapy as initial treatment. Three months after sorafenib induction, main tumor was shrunken and some intrahepatic metastase were disappeared. Right lobectomy as curative resection could be performed. He has no recurrence for 2 years after surgery. 2.) Of 59 patients, over three-years survivors were four patients (L-group) and twenty-three patients were dead within 1 year after sorafenib induction (S-group). Between the two groups, there was no significant difference in age, gender, liver function, and tumor markers. Only the response to sorafenib was significant factors for long-term survival. Sorafenib administration was continued for more than 3 years in two patients of L-group, but withdrawn in two patients. However, other treatments such as TACE or radiation were done soon after withdrawal. Conclusions: Sorafenib combined with surgical treatment may contribute to improve prognosis of patients with initially unresectable HCC.