Prognostic Analysis Of Sorafeinb-assisted High-risk Recurrence Of Hepatocellular Carcinoma After Radical Resection

Purpose:The high recurrence of hepatocellular carcinoma after surgery has always been a matter of close attention in the medical community.Sorafenib in the role of high-risk hepatocellular carcinoma after radical resection is still controversial.This study aims to analyze the therapeutic effect of adjuvant sorafenib for patients with high-risk recurrence of hepatocellular carcinoma after radical resection,to analyze the risk factors that affect the recurrence of hepatocellular carcinoma patients after surgery,to explore whether sorafenib can prolong overall survival and post-recurrence survival,prolong the post-recurrence survival and reduce recurrence rate.Methods:In this study,we retrospectively analyzed the demographics,clinical,pathological,imaging,follow-up information and other data of patients undergoing radical resection of hepatocellular carcinoma at Tianjin Medical University Cancer Institute &Hospital from August 2009 to August 2017.According to postoperative treatment,the patients were divided into sorafenib group and control group.The clinical and pathological information of the two groups of patients was analyzed by the statistical software SPSS26.0.The recurrence-free survival,overall survival,the post-recurrence survival of the two groups of patients were compared,The Cox regression model was used to analyze the risk factors for postoperative survival and recurrence of patients with hepatocellular carcinoma at high risk of recurrence.Results:In the end,223 patients were eligible for data analysis(167 for the control group and 56 for the sorafenib group).The results showed that adjuvant sorafenib did not significantly prolong the recurrence-free survival(15.0 months in the control group vs.27 months in the sorafenib group,P=0.477)and overall survival(34.0 months in the control group vs 42 months in the sorafenib group,P=0.811).Considering the inconsistency of the baseline level between the two groups,a propensity matching analysis was performed.After matching,42 cases in the control group and 42 cases in the sorafenib group were compared.The median overall survival of patients in thesorafenib group was 34 months,and the 1-year,2-year,and 3-year overall survival rates were 90.5%,71.4%,and 49.5%,respectively.The median overall survival of the patients in the control group was 26 months.The overall survival rates at 1 year,2years,and 3 years were 69%,51.7%,and 38.1%,respectively.There was a difference between the two groups and was statistically significant(P=0.032).The median recurrence-free survival in the sorafenib group was 14 months(95% CI: 10.1-30.5months),and the recurrence-free survival rates of 1,2 and 3 years in the sorafenib group were 54.3%,44.4% and 19.8%,respectively.The median recurrence-free survival in the control group was 11.0 months(95% CI: 1.5-20.1 months),and the1-year,2-year,and 3-year relapse-free survival rates of the control group were 51.5%,37.3%,and 22.3%,respectively.There were differences between the groups but the differences are not statistical significance(P=0.564).The post-recurrence survival in the sorafenib group was significantly higher than that of the control group:the median survival period of post-recurrence survival in the control group was 9.4 months(95%CI: 7.06-11.44 months),While in the sorafenib group,the median post-recurrence survival was 15.7 months(95% CI: 11.75-19.78)(P=0.002).Multivariate analysis showed that auxiliary sorafenib was independent risk factors of survival after radical resection of hepatocellular carcinoma.Conclusions:In summary,compared with surgery alone or postoperative combined with other treatments,postoperative adjuvant sorafenib system treatment can not reduce the risk of postoperative recurrence,but it can significantly reduce the mortality and extend the overall survival and postoperative recurrence survival of patients with liver cancer after radical resection.