Sorafenib Decreases Extrahepatic Collaterals in Hepatocellular Carcinoma: Implication of the Synergistic Effect of Sorafenib and Transcatheter Chemoembolization

An old male with multiple hepatocellular carcinomas received six courses of transcatheter arterial chemoembolization. Some tumors supplied by extrahepatic collaterals were seen in treatment period and made it difficult to achieve transcatheter chemoembolization completely. After oral sorafenib treatment and during the 7th transcatheter chemoembolization course, we found that the features of tumor angiogenesis were markedly decreased. Due to disappearance of the extrahepatic collaterals, it took less time (62' 51” vs. 22' 51”) to perform transcatheter chemoembolization. Our case is the first one in the literature to report that antiangiogenic therapy can reduce collateral formation at the gross and angiographic levels, and shows that there may be a synergistic effect between transcatheter chemoembolization and sorafenib.