Treatment of hepatocellular carcinoma with long acting somatostatin analogues.
Samonakis DN., Moschandreas J., Arnaoutis T., Skordilis P., Leontidis C., Vafiades I., Kouroumalis E.
An earlier report has shown that subcutaneous short acting octreotide significantly improves survival of patients with inoperable hepatocellular carcinoma (HCC). The aim of this study was to compare survival of the patients with inoperable HCC treated with long acting somatostatin analogues (LASA) to a historical control group of untreated patients. The survival of 32 patients with inoperable HCC who received LASA treatment was compared to those of 27 untreated patients. The Karnofsky scale was used for assessing quality of life. An improved overall survival was found in the treated group (median survival 15 months, 95% CI 6-24 months for the treated group and 8 months, 95% CI 5-11 months for the controls). The survival benefit remains even after removal of the most advanced cases from the control group. The relative risk of death of the untreated patients is 2.7 (95% CI 1.4-5.3) compared to the treated patients. The tumor remained stable or regressed in 40% of the treated patients. A superior quality of life was found in the treated group. In conclusion long acting somatostatin analogues appear to be beneficial, improving survival and performance status in inoperable HCC cases. Further studies are required to define a subgroup of patients that may benefit to a greater extent than others.