The therapeutic potential of octreotide is further stressed by the fact that BCLC stage-matched patients receiving no active treatment had a shorter survival time than patients

with TACE treatment as expected from the well known fact of a survival benefit of TACE therapy [19, 20]. And yet, TACE treatment was not better than octreotide treatment. Along the same line, the study of Plentz et al [23] showed a similar survival of patients treated with octreotide compared to patients treated with TACE. Treatment with long-acting octreotide [Sandostatin LAR] was excellently tolerated except for a few episodes of soft stools presumably due to the effect of reduced exocrine pancreatic output. This could easily be corrected either with supplementation of pancreatin containing capsules or with loperamid tablets. No intramuscular haematoma formation was observed after i.m. administration of LDK378 mouse long-acting octreotide

[Sandostatin LAR] despite reduced coagulation capacitiy. The interpretation of our data might be limited by the retrospective non-randomised nature of our study and the long time period of recruitment of patients which results in a considerable heterogeneity of the study groups. Although, we tried to match the patients in the study groups according to HIF-1 activation the BCLC system, the best available prognostic staging system, residual heterogeneity in the study population might have influenced the results. In addition, patients under octreotide treatment tended to have lower MELD scores than patients undergoing other treatment modalities although there was no overall difference in MELD score between the various groups. In summary, this retrospective analysis of survival of BCLC stage-matched patients with HCC showed that octreotide

treatment produces a similar survival benefit as TACE or multimodal therapy as compared to no active treatment. Given the few side effects of long-acting octreotide [Sandostatin LAR] this treatment seems to Megestrol Acetate be a therapeutic option for patients with HCC and needs further randomised controlled studies in BCLC stage-matched patients. References 1. Schoniger-Hekele M, Muller C, Kutilek M, Oesterreicher C, Ferenci P, Gangl A: Hepatocellular carcinoma in Central Europe: prognostic features and survival. Gut 2001, 48 (1) : 103–9.CrossRefPubMed 2. Llovet JM, Brú C, Bruix J: Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis 1999, 19 (3) : 329–38.CrossRefPubMed 3. Okuda K, Ohtsuki T, Obata H, et al.: Natural history of hepatocellular carcinoma and prognosis in relation to treatment. Study of 850 patients. Cancer 1985, 56: 918–28.CrossRefPubMed 4. The Cancer of Liver Italian Program (CLIP) Investigators: A new prognostic system for hepatocellular carcinoma: a retrospective study of 435 patients.