GUT 1998;42:442-447 ( March )

Treatment of hepatocellular carcinoma with octreotide: a randomised controlled study

E Kouroumalis,^a P Skordilis,^a K Thermos,^b A Vasilaki,^b J Moschandrea,^c O N Manousos^a

^a Department of Gastroenterology, University Hospital, PO Box 1352, Heraklion 71100, Crete, Greece, ^b Department of Pharmacology, ^c Department of Social Medicine, Biostatistics Laboratory, Medical School, University of Crete

Correspondence to: Professor Kouroumalis.

Accepted for publication 16 July 1997

BackgroundStandard treatment of inoperable hepatocellular carcinoma has not been established. Somatostatin has been shown to possess antimitotic activity against a variety of non-endocrine tumours.
AimsTo assess the presence of somatostatin receptors in human liver and to treat advanced hepatocellular carcinoma with the somatostatin analogue, octreotide.
MethodsSomatostatin receptors were measured in liver tissue homogenates from patients with acute and chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Fifty eight patients with advanced hepatocellular carcinoma were randomised to receive either subcutaneous octreotide 250 µg twice daily, or no treatment. Groups were comparable with respect to age, sex, Okuda classification, presence of cirrhosis, and liver biochemistry and virology.
ResultsVarious amounts of somatostatin receptors were identified in liver tissue of all patients including those with hepatocellular carcinoma. Treated patients had an increased median survival (13 months versus four months, p=0.002, log rank test) and an increased cumulative survival rate at six and 12 months (75% versus 37%, and 56% versus 13% respectively). Octreotide administration significantly reduced  fetoprotein levels at six months. When a multivariable Cox's proportional hazards model was fitted, variables associated with increased survival were: treatment administration, absence of cirrhosis, increased serum albumin, and small tumours. Treated patients clearly had a lower hazard (0.383) in the multivariate analysis.
ConclusionsOctreotide administration significantly improves survival and is a valuable alternative in the treatment of inoperable hepatocellular carcinoma.
(GUT 1998;42:442-447)

Keywords: hepatocellular carcinoma;  octreotide;  somatostatin receptors;  liver disease

---

© 1998 by Gut
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Octreotide in hepatocellular carcinoma

D SHOUVAL
Gut 1998 42: 316-318. [Extract] [Full Text]

This article has been cited by other articles:

• Rahmi, G., Malka, D., Tomasic, G., Dromain, C., Ducreux, M., Boige, V. (2007). Complete, Long-Standing Regression of Hepatocellular Carcinoma After Somatostatin Analogue Treatment. JCO 25: e15-e16 [Full Text]  
• Zhu, A. X. (2006). Systemic Therapy of Advanced Hepatocellular Carcinoma: How Hopeful Should We Be?. The Oncologist 11: 790-800 [Abstract] [Full Text]  
• Barbare, J.-C., Bouche, O., Bonnetain, F., Raoul, J.-L., Rougier, P., Abergel, A., Boige, V., Denis, B., Blanchi, A., Pariente, A., Milan, C., Bedenne, L. (2005). Randomized Controlled Trial of Tamoxifen in Advanced Hepatocellular Carcinoma. JCO 23: 4338-4346 [Abstract] [Full Text]  
• Thomas, M. B., Zhu, A. X. (2005). Hepatocellular Carcinoma: The Need for Progress. JCO 23: 2892-2899 [Full Text]  
• Reynaert, H, Rombouts, K, Vandermonde, A, Urbain, D, Kumar, U, Bioulac-Sage, P, Pinzani, M, Rosenbaum, J, Geerts, A (2004). Expression of somatostatin receptors in normal and cirrhotic human liver and in hepatocellular carcinoma. Gut 53: 1180-1189 [Abstract] [Full Text]  
• Fruhwald, M. C., Rickert, C. H., O'Dorisio, M. S., Madsen, M., Warmuth-Metz, M., Khanna, G., Paulus, W., Kuhl, J., Jurgens, H., Schneider, P., Muller, H. L. (2004). Somatostatin Receptor Subtype 2 Is Expressed by Supratentorial Primitive Neuroectodermal Tumors of Childhood and Can Be Targeted for Somatostatin Receptor Imaging. Clin. Cancer Res. 10: 2997-3006 [Abstract] [Full Text]  
• Siveke, J T, Folwaczny, C, Herberhold, C (2003). Complete regression of advanced HCC with long acting octreotide. Gut 52: 1531-1531 [Full Text]  
• Reubi, J. C. (2003). Peptide Receptors as Molecular Targets for Cancer Diagnosis and Therapy. Endocr. Rev. 24: 389-427 [Abstract] [Full Text]  
• Ryder, S D (2003). Guidelines for the diagnosis and treatment of hepatocellular carcinoma (HCC) in adults. Gut 52: iii1-8 [Full Text]  
• Pistevou-Gombaki, K., Eleftheriadis, N., Plataniotis, G. A, Sofroniadis, I., Kouloulias, V. E (2003). Octreotide for palliative treatment of hepatic metastases from non-neuroendocrine primary tumours: evaluation of quality of life using the EORTC QLQ-C30 questionnaire. Palliat Med 17: 257-262 [Abstract]  
• Ardjomand, N., Ardjomand, N., Schaffler, G., Radner, H., El-Shabrawi, Y. (2003). Expression of Somatostatin Receptors in Uveal Melanomas. IOVS 44: 980-987 [Abstract] [Full Text]  
• Johnson, P J (2002). Hepatocellular carcinoma: is current therapy really altering outcome?. Gut 51: 459-462 [Abstract] [Full Text]  
• Saito, K, Inoue, S, Saito, T, Kiso, S, Ito, N, Tamura, S, Watanabe, H, Takeda, H, Misawa, H, Togashi, H, Matsuzawa, Y, Kawata, S (2002). Augmentation effect of postprandial hyperinsulinaemia on growth of human hepatocellular carcinoma. Gut 51: 100-104 [Abstract] [Full Text]  
• Hejna, M., Schmidinger, M., Raderer, M. (2002). The clinical role of somatostatin analogues as antineoplastic agents: much ado about nothing?. Ann Oncol 13: 653-668 [Abstract] [Full Text]  
• Badvie, S. (2000). Hepatocellular carcinoma. Postgrad. Med. J. 76: 4-11 [Abstract] [Full Text]  
• Reubi, J C, Zimmermann, A, Jonas, S, Waser, B, Neuhaus, P, Laderach, U, Wiedenmann, B (1999). Regulatory peptide receptors in human hepatocellular carcinomas. Gut 45: 766-774 [Abstract] [Full Text]  

eLetters:

Read all eLetters

Complete regression of advanced hepatocellular carcinoma under therapy with long-acting octreotide

Jens T Siveke, et al.

Gut Online, 3 Jun 2003 [Full text]