studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 403A
381
Prediction of Hepatocellular Carcinoma Risk in Patients
with Cirrhosis: Validation of ADRESS–HCC Model
Ju Dong Yang, Hager Ahmed Mohammed, Jonggi Choi, Gregory
J. Gores, Lewis R. Roberts, W. Ray Kim; Division of Gastroenterology
and Hepatology, Mayo Clinic College of Medicine, Rochester,
MN
Background/Aims: ADRESS-HCC is a model to predict the risk
of hepatocellular carcinoma (HCC) in patients with cirrhosis
[Cancer 2014;3485]. It incorporates age, diabetes, race,
etiology and severity of cirrhosis, and sex. In this study, we
validate the model in an independent cohort of patients. Methods:
Of all cirrhotic patients seen at Mayo Clinic Rochester
between January 2006 and December 2011, those who had
liver images (US, CT, or MRI) at baseline and at follow up more
than 6 months from baseline were included. The ADRESS risk
score was calculated by the following: score= [age]*0.0532+
[1 for diabetes]*0.2135 + [1 for nonwhite/Hispanic]*0.2058
+ [1 for metabolic/alcohol etiology]*0.3509 + [1 for viral
etiology]*1.246 + [1 for male]*0.5114 + [Child-Turcotte-Pugh
(CTP) score]*0.1170. Observed incidence of HCC was compared
to the model’s prediction. Results: A total of 739 cirrhotic
patients met the eligibility criteria. The mean age was 57.4
years, with 59% men, 90% non-Hispanic White and 34% diabetic.
The etiology of liver disease was alcoholic in 32%, viral
in 23% and metabolic in 23%. The mean CTP score was 8.
After a median follow up of 38 months, 69 (9%) patients developed
HCC. The median ADRESS score was 5.01 (interquartile
range: 4.44-5.46). Figure divides patients into 3 groups by
the ADRESS score quartiles: the top (high risk) quartile (hazard
ratio [HR]=6.8; 95%CI=2.9-20.2) and the middle two quartiles
(HR=3.2; 95%CI=1.4-9.4) had a significantly higher incidence
of HCC compare to the lowest risk quartile. When the surveillance
threshold (ADRESS=4.67 with predicted annual incidence=1.5%)
was applied, 0.97% of patients developed HCC
in the first 18 months. Conclusions: Based on an independent
cohort of cirrhotic patients, we validate ADRESS-HCC model as
a useful tool for predicting the risk of HCC among patients with
cirrhosis and identifying candidates for surveillance.
Disclosures:
Douglas Dieterich - Advisory Committees or Review Panels: Gilead, BMS, Abbvie,
Janssen, Merck, Achillion
The following authors have nothing to disclose: Beatriz Minguez, Ayse Aytaman,
Meritxell Ventura-Cots, Maaz B. Badshah, Caitlin C. Citti, Heather L. Platt, Ting-Yi
Chen, Luciana Kikuchi, Sonja Marcus, Michael Yin, Judith Aberg, Myron E.
Schwartz, Norbert Bräu
Disclosures:
Gregory J. Gores - Advisory Committees or Review Panels: Conatus
Lewis R. Roberts - Grant/Research Support: Bristol Myers Squibb, ARIAD Pharmaceuticals,
BTG, Wako Diagnostics, Inova Diagnostics, Gilead Sciences, Five
Prime Therapeutics
W. Ray Kim - Advisory Committees or Review Panels: Bristol Myers Squibb,
Gilead Sciences, Abbvie, Merck
The following authors have nothing to disclose: Ju Dong Yang, Hager Ahmed
Mohammed, Jonggi Choi
382
The life time frequency and interval of treatments define
the prognosis of hepatocellular carcinoma after radical
radiofrequency ablation therapy
Takamasa Ohki, Yuki Hayata, Satoshi Kawamura, Daisaku Ito,
Koki Kawanishi, Kentaro Kojima, Michiharu Seki, Nobuo Toda,
Kazumi Tagawa; Gastroenterology, Mitsui Memorial Hospital,
Tokyo, Japan
Backgrounds and Aims: Hepatocellular carcinoma (HCC)
frequently recurs even after curative radiofrequency ablation
(RFA) therapy and the recurrence rate is approximately 50%
within 3 years. Thus, the treatment strategy after HCC recurrence
is very important to achieve a long term survival. We
analyzed the life time frequency and interval of treatments to
evaluate their impacts on overall survival (OS). Patients and
methods: In this retrospective study, we enrolled 305 naïve
HCC patients who were curatively treated with RFA between
January 1 2000 and December 31 2010. The last follow-up
date was December 31 2014. The rate of life time frequency of
treatments per year (LFT rate) was calculated as total numbers
of treatments divided by observational year. The total numbers
of treatments were defined as sum of frequency of RFA and
trans-catheter chemo-embolization or infusion (TACE or TAI)
times. Patients were stratified into four groups to compare the
OS according to LFT rate: group A; LFT rate < 0.5 N = 53,
group B; 0.5 ≤ LFT rate < 1.0 N = 69, group C; 1.0 ≤ LFT rate
< 2.0 N = 103, and group D; 2.0 ≤ LFT rate N = 80. Results:
During the mean follow-up of 4.7 years, the life time frequency
of treatments was 5.2 times on average. The frequency of each
treatment modality was as follows: RFA 2.8 and TACE or TAI
2.3 times. One-hundred fifty-eight patients died during the follow-up
period, showing cumulative survival rates at 3, 5 and