Tamoxifen compared to best supportive care in advanced hepatocelluar carcinoma: A retrospective matched-cohort study

Background: hepatocelluar carcinoma (hcc) is a common cancer worldwide as well as in egypt with hepatitis b and c,alcohol and aflatoxins being the commonest risk factors. tamoxifen was initially reported to confer a marginal survival benefit in advanced hcc. however,later reports declined any benefit. objective: to study the impact of tamoxifen on overall survival (os) compared to best supportive care (bsc) in egyptian patients with advanced hcc. methods: this retrospective matched-cohort study was conducted at tanta cancer center (tcc),egypt where 116 advanced hcc cases treated with tamoxifen were compared to tnm stage and child-pugh class matched 116 hcc cases who received bsc. results: the median os in the tamoxifen group was 9.3. months (95% confidence interval [ci],6.7-11.9. months) compared to 8.7. months (95%ci,6.8-10.6) in the bsc group (p=0.758). with univariate analyses,it was shown that absence of fatigue,child-pugh class a,single tumors,less advanced tumors (t2),and absence of metastases (m0),had significantly better os than their counterparts. multivariate analysis showed that absence of fatigue,child-pugh class a and t2 tumors were independent prognostic factors affecting os. tamoxifen produced partial response and clinical stabilization in one% and 16% of cases,respectively. the median pfs with tamoxifen was 7.2. months (95%ci,5.2-9.5). conclusions: tamoxifen did not show any os advantage in egyptian patients with advanced hcc. use of this drug is discouraged. © 2013.