OBJECTIVE : To retrospectively evaluate the tolerance and the prognostic factorsassociated with better outcome in patients treated with sorafenib for advanced orrefractory/relapsing intermediate hepatocellular carcinoma (HCC) in real-life clinicalpractice, including the specific influence of visceral fat area (VFA).METHODS : 68 HCC patients treated with sorafenib and followed in Hepato-gastroenterology department of Nancy Universitary Hospital from 2007 to 2012 were enrolled. VFA was retrospectively measured on one cross-sectional scan obtained at the umbilicus on CT scan performed within 1 year prior to sorafenib initiation. Tumour response was retrospectively evaluated according to mRECIST criteria. Overall survival (OS) and progression free survival (PFS) were determined. Safety data were collected.RESULTS: Median OS was 12.0 months and median PFS was 3.0 months. In multivariate analysis, a PS > 1, the presence of vascular invasion and high ASAT baseline levels were significantly associated with shorter OS (HR respectively of 2.41, 2.43 and 1.51). PS > 1, high ASAT baseline levels and a Child-Pugh score > B7 were independent predictive factors of shorter PFS (HR respectively of 1.51, 1.4 and 1.47). Semi-quantitative prognostic scores for OS and PFS were determined. Half of patients presented adverse events leading to definitive discontinuation of sorafenib. The most frequent adverse events were diarrhea (33.5%), fatigue (30.9%) and hand-foot syndrome reaction (23.5%).CONCLUSION : No impact of VFA on survival was identified. The developed semiquantitative prognostic scores could be useful to identify HCC patients who could take the most advantage from sorafenib therapy