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Japanese Journal of Clinical Oncology Advance Access originally published online on August 20, 2008
Japanese Journal of Clinical Oncology 2008 38(10):675-682; doi:10.1093/jjco/hyn087
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© The Author (2008). Published by Oxford University Press. All rights reserved

Predictive Factors of Outcome and Tumor Response to Systemic Chemotherapy in Patients with Metastatic Hepatocellular Carcinoma

Masafumi Ikeda1,2, Takuji Okusaka1, Hideki Ueno1, Chigusa Morizane1, Yasushi Kojima1, Satoru Iwasa1 and Atsushi Hagihara1

1 Division of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo
2 Division of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan

For reprints and all correspondence: Masafumi Ikeda, Division of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan. E-mail: masikeda{at}east.ncc.go.jp

Received May 10, 2008; accepted July 25, 2008

Objective: Systemic chemotherapy is an important treatment modality for metastatic hepatocellular carcinoma (HCC); however, the predictive factors of outcome and tumor response have not been fully investigated. The aim of this study was to identify factors that could be used to predict outcome and tumor response to systemic chemotherapy in patients with metastatic HCC.

Methods: We retrospectively examined 82 consecutive patients with metastatic HCC undergoing systemic chemotherapy to investigate factors associated with outcome and tumor response. The patients underwent 5-fluorouracil, mitoxantrone and cisplatin (FMP) therapy.

Results: The overall objective response rate was 22% (95% confidence interval, 14–32), and the median survival time and 1-year survival for all patients were 11.2 months and 43.5%, respectively. Multivariate analysis demonstrated that the absence of radiologically active intrahepatic disease (P = 0.02) and ascites (P = 0.002) was independent favorable prognostic factors. Although multivariate analysis revealed no significant predictive factors of tumor response, the response rates in patients without radiologically active intrahepatic disease (response rate, 46%) tended to be higher than those in patients with active intrahepatic disease (response rate, 17%) (P = 0.05).

Conclusion: Patients with metastatic HCC, who had sufficient hepatic function and no radiologically active intrahepatic disease, might be good candidates for systemic chemotherapy.

Key Words: hepatocellular carcinoma • prognostic factor • tumor response • chemotherapy • metastasis


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