Combined endovascular brachytherapy, sorafenib, and transarterial chemobolization therapy for hepatocellular carcinoma patients with portal vein tumor thrombus

Table 1 Baseline characteristics of overall patients n (%)

Characteristic	Group A	Group B
	(n = 37)	(n = 31)
Sex
Male	34 (91.9)	26 (83.9)
Female	3 (8.1)	5 (16.1)
Age, yr (%)
≥ 55 yr	18 (48.9)	14 (45.2)
< 55 yr	19 (51.4)	17 (54.8)
Type of tumor
Nodular	30 (81.1)	29 (93.5)
Infiltrative	7 (18.9)	2 (6.5)
HCC maximum diameter
≥ 5 cm	26 (70.3)	19 (61.3)
< 5 cm	11 (29.7)	12 (38.7)
Degree of MPVTT
Stenosis	31 (83.8)	24 (77.4)
Occlusive	6 (16.2)	7 (22.6)
Child-pugh class
A	33 (89.2)	24 (77.4)
B	4 (10.8)	7 (22.6)
ECOG performance status
0/1	33 (89.2)	26 (83.9)
2	4 (10.8)	5 (16.1)
Etiology of liver disease
HBV	35 (94.6)	29 (93.5)
Other	2 (5.4)	2 (6.5)
Serum AFP level (in ng/mL)
≥ 400	20 (54.1)	17 (54.8)
< 400	17 (45.9)	14 (45.2)
Extrahepatic metastasis	3 (8.1)	3 (9.7)

AFP: Alfa-fetoprotein; ECOG: Eastern cooperative oncology group; HBV: Hepatitis B virus; MPVTT: Main portal vein tumor thrombus; HCC: Hepatocellular carcinoma.

Table 2 Baseline characteristics of propensity-matched patients n (%)

Characteristic	Group A	Group B
	(n = 24)	(n = 24)
Sex
Male	22 (91.7)	23 (95.8)
Female	2 (8.3)	1 (4.2)
Age
≥ 55 yr	14 (58.3)	9 (37.5)
< 55 yr	10 (41.7)	15 (62.5)
Type of tumor
Nodular	21 (87.5)	22 (91.7)
Infiltrative	3 (12.5)	2 (8.3)
HCC maximum diameter
≥ 5 cm	16 (66.7)	17 (70.8)
< 5 cm	8 (33.3)	7 (29.2)
Degree of MPVTT
Stenosis	21 (87.5)	19 (79.2)
Occlusive	3 (12.5)	5 (20.8)
Child-pugh class
A	20 (83.3)	21 (87.5)
B	4 (16.7)	3 (12.5)
ECOG performance status
0/1	20(83.3)	22(91.7)
2	4(16.7)	2(8.3)
Etiology of liver disease
HBV	22 (91.7)	23 (87.5)
Other	2 (8.3)	1 (12.5)
Serum AFP level
≥ 400	12 (50.0)	10 (41.7)
< 400	12 (50.0)	14 (58.3)
Extrahepatic metastasis	1 (3.8)	3 (11.5)

AFP: Alfa-fetoprotein; ECOG: Eastern cooperative oncology group; HBV: Hepatitis B virus; MPVTT: Main portal vein tumor thrombus; HCC: Hepatocellular carcinoma.

Table 3 Log-rank test and cox regression analysis of factors potentially related to overall survival

	Group A vs Group B
	Log-rank test		Cox regression
Factors	n	P	HR (95%CI)	P
Treatment regimen	-	< 0.001	-	-
EVBT-stenting-TACE-sorafenib	37		0.18 (0.09-0.35)	< 0.001
TACE-sorafenib	31		1	-
Type of tumor		0.466	-	-
Nodular type	59		-	-
Diffuse type	9		-	-
HCC maximum diameter	-	0.320	-	-
≥ 5 cm	45		-	-
< 5 cm	23		-	-
Child-pugh class		0.298	-	-
A	57		-	-
B	11		-	-
ECOG performance status	-	0.125	-	-
0 and 1	59		-	-
2	9		-	-
Extrahepatic metastasis	-	0.742	-	-
Yes	62		-	-
No	6		-	-
Serum AFP level (ng/mL)	-	0.586	-	-
≥ 400	37		-	-
< 400	31		-	-

AFP: Alfa-fetoprotein; ECOG: Eastern cooperative oncology group; TACE: Transarterial chemoembolization.

Table 4 Adverse events related to sorafenib administration and transarterial chemoembolization in the two groups n (%)

Adverse event	Group A	Group A	P
	(n = 37)	(n = 31)
Sorafenib related AEs
Hand-foot skin reaction
Grade 1-2	26 (92.9)	27 (96.4)	0.143
Grade 3-4	2 (7.1)	1 (3.6)	0.593
Diarrhea
Grade 1-2	23 (88.5)	18 (94.7)	0.994
Grade 3-4	3 (11.5)	1 (3.6)	0.620
Hypertension
Grade 1-2	8 (21.6)	6 (19.4)	0.818
Grade 3-4	1 (3.2)	0	1.000
Alopecia
Grade 1-2	2 (7.1)	4 (12.9)	0.400
Grade 3-4	0	0
Fatigue
Grade 1-2	9 (24.3)	4 (12.9)	0.354
Grade 3-4	0	0
Voice change
Grade 1-2	0	1 (3.6)	464
Grade 3-4	0	0
Epistaxis
Grade 1-2	2 (7.1)	2 (6.5)	1.000
Grade 3-4	0	0
TACE related AEs
New ascites	4 (10.8)	11 (35.5)	0.020
Liver dysfunction	2 (16.2)	15 (48.4)	< 0.000
Gastrointestinal hemorrhage	0	8 (25.8)	0.001
Hepatorenal syndrome	0	2 (6.5)	0.204
Liver abscess	0	0	-
Spontaneous bacterial peritonitis	0	0	-
Inguinal hematoma	0	0	-
Pulmonary/cerebral oil embolization	0	0	-

TACE: Transarterial chemoembolization.