DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20170039

Clinical profile of hepatocellular carcinoma and experience with sorafenib from a tertiary cancer centre in Southern India

Manjunath I. Nandennavar, Shashidhar V. Karpurmath, Ganesh Mandakalatur, Aruna E. Prasad

Abstract


Background: Hepatocellular carcinoma is a major health problem and a major cause of cancer mortality in India. There are no reports published on experience with sorafenib in advanced HCC from India. We analyzed the clinical presentation, possible etiological factors, tumor characteristics, outcomes and tolerability of sorafenib in the patients presenting to present cancer center.

Methods: Retrospective chart review of 53 patients was done. 53 patients (male 37, female 16; median age 52 years, range 7-80 years) fulfilling the diagnostic criteria were analyzed for clinical characteristics, hematological and biochemical investigations, tumor characteristics, treatment taken and outcome.

Results: 53 patients were diagnosed to have HCC between 2012-2015. Hepatitis B virus infection was the most common underlying etiologic factor (22.6%). Heavy alcohol intake was seen in 5 patients. PS ≥2 was noted in 66% of patients. 68% of the patients had BCLC stage C. Sorafenib was well tolerated with median OS of 3 months in patients taking sorafenib.

Conclusions: Most of the patients had advanced inoperable HCC. Majority of the patients presented with BCLC Stage C and D. Hepatitis B infection was the most common underlying etiology. Sorafenib was well tolerated. More prospective studies are required for getting a clearer and correct picture of HCC and experience with sorafenib in Indian scenario.


Keywords


BCLC stage, Clinical profile, Hepatitis B, Hepatocellular carcinoma, Sorafenib, South India

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References


Venook AP, Papandreaou P, Furusi J, Ladran de, Guevara L. The incidence and epidemiology of hepatocellular carcinoma: A global and regional perspective. The Oncologist. 2010;15:5-13.

London WT, McGlynn KA. Liver cancer. In: Schottenfeld D, Fraumeni J Jr, eds. Cancer Epidemiology and Prevention. 3rd ed. New York: Oxford University Press. 2006:763-86.

Torre LA, Bray F, Siegel RL, Ferlay J, Lortet- Tiulent J, Jemal A. Global cancer statistics, 2012. Ca Cancer J Clin. 2015;65:85-108.

Mallath MK, Taylor DG, Badwe R, Rath G, Shanta V, Pramesh CS et al. The growing burden of cancer in India: epidemiology and social context. Lancet Oncol. 2014;205-12.

Acharya SK. Epidemiology of hepatocellular carcinoma in India. J ClinExpHepatol. 2014;4:S27-33.

Paul S, Chalamalasetty SB, Visnubhatla S, Madan K, Gamanagatti S, Batra Y, et al. Clinical profile, etiology and therapeutic outcome in 324 hepatocellular carcinoma patients at a tertiary cancer centre in India. Oncology. 2009;77:162-71.

Paul SB, Shreenivasa V, Gulati MS, Madan K, Gupta AK, Mukhopadhyaya S, et al. Incidence of hepatocellular carcinoma among Indian patients with liver cirrhosis: an experience from a tertiary cancer centre in northern India. Indian J Gastroenterol. 2007;26:274-8.

Bhattacharya GS, GovindBabu K, Malhotra H, Ranade AA, Murshed S, Dutta D. Hepatocellular carcinoma in India. Chin ClinOncol. 2013;2(4):41.

Kar P. Risk factors for hepatocellular carcinoma in India. J ClinExp Hepatol. 2014;4:s34-42.

Kumar R, Saraswat MK, Sharma BC, Sakhuja P, Sarin SK. Characteristics of hepatocellular carcinoma in India: a retrospective analysis of 191 cases. Q J Med. 2008;101:479-85.

Sarin SK, Thakur V, Guptan RC, Saigal S, Malhotra V, Thyagarajan S, et al. Profile of hepatocellular carcinoma in india: An insight into the possible etiologic considerations. J GastroenterolHepatol 2001;16:666-73.

Mittal S, El Serag HB. Epidemiology of Hepatocellular carcinoma: Consider the population. J ClinGastroenterol. 2013;47:s42-6.

Seef LB, Hoofnagle JH. Epidemiology of hepatocellular carcinoma in areas of low hepatitis B and hepatitis C endemicity. Oncogene. 2006;25:3771-77.

El Serag HB. Epidemiology of viral hepatitis and hepatocellular carcinoma. Gastroenterology. 2012;142:1264-73.

Chen CJ, Iloeje UH, Yang H. The long term outcomes in hepatitis B: the REVEAL HBV study. Clin Liver Dis. 2007;11:797-816.

Sanyal AJ, Yeun SK, Lencioni R. The etiology of hepatocellular carcinoma and its consequences for treatment. The Oncologist. 2010;15:14-22.

Bruix J, Sherman M, Llovet JM, Beaugrand M, Lencioni R, Burroughs AK, et al. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASLConference. J Hepatol. 2001;35:421-30.

Mukherjee S, Dhar K, Datta S, Mukherjee AK. Hepatocellular carcinoma in Eastern India, a detail analytical report from a tertiary cancer hospital. Int J Sci Rep. 2015;1:69-73.

Sood A, Midha V, Goyal O, Goyal P, Sood N, Sharma SK. Profile of hepatocellular carcinoma in a tertiary cancer centre in Punjab in northern India. Indian J Gastroenterol. 2014;33:35-40.

Nagaich N, Sharma R, Katiyar P, Nagaich Y, Sharma I, Nijhawan S. Spectrum of hepatocellular carcinoma: Study from a tertiary cancer centre. J Cancer PrevCurr Res. 2016;4:00141.

Llovet JM, Ricci S, Mazzaferro V, Hilgard P, Gane E, Blanc JF, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008;359:378-90.

Bruix J, Raoul JL, Sherman M, Mazzaferro V, Bolondi L, Craxi A. Efficacy and safety of sorafenib in patients with advanced hepatocellular carcinoma: A phase III trial. J Hepatol. 2012;57:821-9.

Kostner AH, Sorensen M, Olesen RK, Gronbaek H, Lassen U, Ladekarl M. Sorafenib in advanced hepatocellular carcinoma: A nationwide retrospective study of efficacy and tolerability. Sci World J. 2013; article ID931972.

Lee SH, Song IH, Noh R, Kang HY, Kim SB, Ko SY. Clinical outcomes of patients with hepatocellular carcinoma treated with sorafenib: a retrospective study of routine clinical practice in multiinstitutions. BMC Cancer. 2015;15:236.