studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 385A
Multivariate Cox proportional hazards model analysis for risk of
overall mortality
Disclosures:
The following authors have nothing to disclose: Teng-Yu Lee, Yi-Ju Chen, Jaw-
Town Lin, Hsiu-Jon Ho, Ming-Shiang Wu, Chun-Ying Wu
Disclosures:
Imam Waked - Advisory Committees or Review Panels: Janssen; Speaking and
Teaching: Hoffman L Roche, Merck, BMS, Gilead, AbbVie
Bruno Sangro - Speaking and Teaching: Sirtex Medical Europe, Bayer Schering
Pharma
Nicholas Stern - Speaking and Teaching: Bayer Pharmaceuticals
The following authors have nothing to disclose: Sarah Berhane, Stephen L. Chan,
Asmaa Gomaa, Mercedes Iñarrairaegui, Zahraa Alkhatib, Takashi Kumada,
Paul B. Lai, Tim Meyer, Frankie Mo, Daniel Palmer, Toshifumi Tada, Hidenori
Toyoda, Arndt Vogel, Winnie Yeo, Phillip Johnson
345
Nucleos(t)ide analogue therapy in relation to survival
after transarterial chemoembolization for HBV-related
hepatocellular carcinoma
Teng-Yu Lee 1 , Yi-Ju Chen 1 , Jaw-Town Lin 2 , Hsiu-Jon Ho 2 , Ming-Shiang
Wu 3 , Chun-Ying Wu 1 ; 1 Taichung Veterans General Hospital,
Taichung, Taiwan; 2 Fu Jen Catholic University, New Taipei City,
Taiwan; 3 National Taiwan University Hospital, Taipei, Taiwan
Transarterial chemoembolization (TACE) is the most widely
used primary treatment for unresectable hepatocellular carcinoma
(HCC), but patient survival is unsatisfactory. We aimed
to investigate the association between nucleos(t)ide analogue
(NA) therapy and patient survival in hepatitis B virus (HBV)-related
HCC following TACE. Using the Taiwan National Health
Insurance Research Database between October 1, 2003 and
December 31, 2011, we screened 57,566 patients with newly
diagnosed HCC. Excluding patients with advanced HCC, we
identified 5,182 patients who received TACE for HBV-related
HCC (869 used NAs 90 days and 4,313 never used NA
after TACE). Patients in the NA-treated cohort were randomly
matched 1:4 with patients in the untreated cohort by age, sex,
cirrhosis, coexisting diseases and the time period between
TACE and initiation of NA therapy. Finally, 582 patients were
recruited in the NA-treated group and 2,328 in the untreated
group. Cumulative incidences of and hazard ratios (HRs) for
patient mortality were analyzed. The mortality rates of the
NA-treated group were significantly lower than those of the
untreated group (1-year: 43.5%, 95% confidence interval [CI]:
39.3-47.7% vs. 56.8%, 95%CI: 54.7-58.9%; 2-year: 58.4%,
95%CI: 53.9-62.9% vs. 74.5%, 95%CI: 52.3-76.6%; 5-year:
78.4%, 95%CI: 73.2-83.6% vs. 88.6%, 95%CI: 86.3-90.8%;
P< 0.001). In multivariate regression analysis, NA therapy was
independently associated with a decreased mortality risk (HR
0.66, 95%CI: 0.59-0.75; P< 0.001). Multivariate stratified
analyses verified the association of NA therapy and decreased
mortality in all patient subgroups. Conclusion: NA therapy was
associated with a decreased mortality among patients with
HBV-related HCC following TACE.
346
Risk assessment of hepatocellular carcinoma in chronic
hepatitis B patients with long-term antiviral therapy
Kyu sik Chung, Do Young Kim, Beom Kyung Kim, Seung Up Kim,
Jun Yong Park, Hye Jin Ku, Kwang-Hyub Han, Sang Hoon Ahn;
Department of Internal Medicine, Yonsei University College of
Medicine, Seoul, Korea (the Republic of)
Background: In the era of potent antiviral therapy, the prognostic
significance of a biological gradient of serum HBV-DNA levels
measured at given time points has substantially diminished,
another predictive factors, determining the long-term prognosis
such as hepatocellular carcinoma (HCC) development, are
required Methods: The aim of this study was to evaluate the
incidence and risk factor of HCC occurrence in a large group
of treatment-naïve chronic hepatitis B (CHB) patients, treated
with entecavir (ETV) or tenofovir (TDF). Additionally, predictive
accuracy of published HBV-HCC risk scores (CU-HCC
score, GAG-HCC score, REACH-B score and LSM-HCC score)
were evaluated. Results: A total of 762 CHB patients, who
were treated with ETV (n=546) or TDF (n=216), were consecutively
enrolled in this study. The median age (486 males and
276females) was 51 years and 261 (34.3%) patients have
liver cirrhosis. During the median follow-up of 45.8 months,
HCC developed in 39 patients (5.1%) and the 1-, 3-, 5-, and
7-year cumulative incidences of HCC were 1.6%, 4.0%, 7.2%
and 9.5%, respectively. In multivariate analysis, old age (hazard
ratio [HR] 1.091; 95% confidence interval [CI], 1.040-
1.144;P0.05). In terms of HCC
development at 3-/5-years, the AUROC of CU-HCC score were
0.851/0.846, LSM-HCC score, 0.772/0.763, GAG-HCC
score, 0.719/0.739, and REACH-B score, 0.710/0.691, indicating
that liver fibrotic burden need to be incorporated properly
into HBV-HCC prediction models to improve predictive
performance. Conclusions: In the era of antiviral therapy, individual
risks of HBV-HCC should be assessed effectively based
on age and the fibrotic burden, not serum HBV-DNA level or
virological response to antiviral therapy.
Disclosures:
The following authors have nothing to disclose: Kyu sik Chung, Do Young Kim,
Beom Kyung Kim, Seung Up Kim, Jun Yong Park, Hye Jin Ku, Kwang-Hyub Han,
Sang Hoon Ahn