Abstract

Objectives: Liver cancer ranks third in terms of mortality worldwide. Sorafenib is a tyrosine kinase inhibitor that was approved for patients with advanced hepatocellular cancer (HCC). There are not many large-scale studies comparing sorafenib with chemotherapy. We planned to compare the effectiveness of sorafenib and chemotherapy in advanced-stage HCC patients.

Materials and Methods: Patients over the age of 18, who were followed up with a diagnosis of advanced stage HCC in the Medical Oncology Department at Ankara University Faculty of Medicine between 2012 and 2022, who received sorafenib or FOLFOX/CAPOX treatment as first-line treatment, were included in the study. Patient and disease characteristics were recorded from the hospital database (Avicenna) and compared statistically.

Results: Forty-four patients were included. The Eastern Cooperative Oncology Group performance status of all patients was 0-1. Nine (22.5%) patients had liver cirrhosis. The distribution of Child-Pugh scores was similar between groups (p=0.45). It was seen that 22 (50%) patients had stage A-B disease and 22 (50%) patients had stage C disease. It was recorded that 37 (84.1%) patients received sorafenib and 7 (15.9%) patients received FOLFOX/CAPOX treatment. Progression-free survival was measured as 2 months for the FOLFOX/CAPOX arm and 1 month for the sorafenib arm (p=0.96, log-rank). Overall survival was measured as 8.8 months in the FOLFOX/CAPOX arm and 6.3 months in the sorafenib arm (p=0.29, log-rank).

Conclusion: No difference in survival was demonstrated between sorafenib and FOLFOX/CAPOX treatment. Multicenter and larger population studies are needed to elucidate the place of fluoropyrimidine and oxaliplatin combination in HCC treatment.