The Effect of Sorafenib on Portal Pressure

Inclusion Criteria

• •Age 20-75 years
• •Cirrhosis diagnosed by liver biopsy or by imaging studies showing a nodular liver, splenomegaly and/or collaterals
• •HCC proven histologically or diagnosed following the AASLD criteria if biopsy not feasible or refused by the patient
• •HCC must be unresectable and within UCSF criteria (single tumor ≤ 6.5 cm diameter, or, if multiple lesions, maximum diameter of the largest lesion ≤ 4.5 and total tumor diameter ≤ 8 cm (23))
• •CPT score \<9 (that is all Child A and Child B with a score of 7 or 8)
• •Complete response to treatment with RFA (including that performed laparoscopically) or TACE or a combination of the above as defined by radiologic criteria (hepatoma protocol MRI or CT scan performed 4-6 weeks after the procedure).
• •No more than two ablative procedures prior to enrollment
• •Presence of portal hypertension, as defined by HVPG of \>5 mmHg
• •EGD for variceal screening performed within 6 months of entry into the study unless the patient is already on a stable dose of a non selective beta-blocker (adjusted to obtain a heart rate of 55-60 bpm) or treated with variceal band ligation.
• •Women of childbearing potential must have a negative serum pregnancy test performed within 7 days prior to the start of treatment
• •Women of childbearing potential and men must agree to use adequate contraception (barrier method of birth control) prior to study entry and for the duration of study participation. Men should use adequate birth control for at least three months after the last administration of sorafenib.
• •Signed informed consent