Objective  To evaluate the efficacy and analyze the prognostic factors of sorafenib treatment in patients with advanced hepatocellular carcinoma (HCC).

  Methods  Baseline characteristics and outcomes of 110 patients with advanced HCC treated with sorafenib with/without local therapy from a single liver cancer center were collected. Predictors of progress-free survival (PFS) and overall survival (OS) were determined by multivariable analysis.

  Results  Complete response was observed in 14 patients (12.7%), partial response (PR) in 16 patients (14.5%), and stable disease (SD) in 40 patients (36.4%). The therapeutic effective rate was 63.6%. The median OS and PFS for the entire cohort were 10.5 months (95% CI, 8.7-12.3 months) and 5.0 months (95% CI, 3.7-6.3 months), respectively. Sorafenib combined with local treatment (transarterial chemoembolization with/without cryoablation) was an independent predictor of good PFS. Two negative factors, namely, the Eastern Cooperative Oncology Group (ECOG) performance status (PS) and Child-Pugh class, predicted poor PFS independently. The ECOG PS and alfa-fetoprotein were found to be independent adverse predictors of the OS, whereas the combination of local treatment was an independent predictor of good OS. In a subset of patients with progressive disease, a significant difference was found between the OS rates of patients with continuous sorafenib treatment and those who discontinued the therapy (11 months vs. 7.5 months, P < 0.001).

  Conclusion  The ECOG PS is an important predictor for survival rate of patients with advanced HCC. Sorafenib combined with local therapy may achieve better outcomes for these patients. The survival benefit of the combined treatment of sorafenib with local therapy warrants further studies.