Clinical outcomes of sorafenib treatment in Child-Pugh B hepatocellular carcinoma patients: a retrospective single-center study

Aim: Hepatocellular carcinoma (HCC) is a leading cause of liver-related mortality, particularly in patients with cirrhosis. Sorafenib is one of the primary systemic therapies for advanced HCC. This study aimed to evaluate the clinical outcomes and prognostic factors associated with sorafenib treatment in this patient population. Material and Methods: This retrospective, single-center study included 28 patients with Child-Pugh B HCC who were treated with sorafenib. Patient characteristics, overall survival (OS), and progression-free survival (PFS) were analyzed. Kaplan-Meier survival analysis and Cox regression were used to assess prognostic factors, including transarterial chemoembolization (TACE), transarterial radioembolization (TARE), and tumor size. Results: Among the 28 patients, 85.7% were male and 89.3% had cirrhosis. Biopsy was performed in 64.3% of cases, and extrahepatic spread was observed in only 3.6%. Tumor size exceeded 5 cm in 67.9% of patients. Disease control was achieved in 57.1% with stable disease (SD), 10.7% showed partial response (PR), and 32.1% experienced progressive disease (PD). Median OS and PFS were 8.1 and 5.9 months, respectively. Cox regression analysis did not identify TACE, TARE, or tumor size as statistically significant prognostic factors. Conclusion: Sorafenib led to disease stabilization in over half of the patients, although one-third experienced disease progression. Compared to the SHARP and Asia-Pacific trials, our study yielded different outcomes, likely due to the exclusive inclusion of patients with Child-Pugh B score of 7. These findings underscore the need for improved patient selection, potential combination therapies, and the identification of predictive biomarkers to enhance treatment efficacy.