studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 413A
right upper quadrant pain (24%), and hepatomegaly (24%).
Routine screening detected carcinoma in 9/25 patients; 8/9
of those screened cases were caught at an early stage with a
single tumor. Prior to diagnosis with HCC, the median interval
since prior imaging was 12 (1-42) months. Patients without
prior or recent (within 12 months) liver imaging were more
likely to present with multiple liver masses or metastatic disease
(91%). Moreover, 88% of patients deceased before 1 year
after diagnosis had no prior or recent screening. Conclusion:
Patients with Fontan circulation are at increased risk to develop
late hepatocellular cancer and should be screened according
to guidelines. Early diagnosis of hepatocellular carcinoma may
allow for improved treatment strategies and prolonged survival.
Presenting Stages of Hepatocellular Carcinoma
for Epi-TACE group and 869 days for Cis-TACE group (HR:
1.18, 95% CI:0.57-2.44, p = 0.658). In subgroup analysis for
the primary treatment, response rate was significantly better in
Epi-TACE group than in Cis-TACE group (64.3% versus 8.3%,
respectively, p = 0.002), though they were comparable in
subgroup analysis for the non-primary treatment (16.7% versus
26.7%, respectively, p = 0.531). Conclusions This prospective
randomized controlled study demonstrated that Epi-TACE might
be more effective than Cis-TACE. Epirubicin might be used
for the primary TACE, and cisplatin might be alternatives as
non-primary TACE.
Disclosures:
Etsuro Hatano - Speaking and Teaching: Bayer
The following authors have nothing to disclose: Yosuke Kasai, Kohta Iguchi,
Rinpei Imamine, Takahiro Nishio, Masayuki Okuno, Satoru Seo, Kojiro Taura,
Kentaro Yasuchika, Toshiya Shibata, Shinji Uemoto
Disclosures:
Daniel Ganger - Advisory Committees or Review Panels: Bristol Myers, Abbvie;
Grant/Research Support: Merck, Ocera; Speaking and Teaching: Gilead
The following authors have nothing to disclose: Laura J. Dickmeyer, Barbara J.
Deal, Andrew Defreitas
402
A randomized controlled study of effectiveness between
transcatheter arterial chemoembolization with epirubicin
versus cisplatin for multiple hepatocellular carcinoma
Yosuke Kasai 1 , Etsuro Hatano 1 , Kohta Iguchi 1 , Rinpei Imamine 2 ,
Takahiro Nishio 1 , Masayuki Okuno 1 , Satoru Seo 1 , Kojiro Taura 1 ,
Kentaro Yasuchika 1 , Toshiya Shibata 2 , Shinji Uemoto 1 ; 1 Department
of Surgery, Graduate School of Medicine, Kyoto University,
Kyoto, Japan; 2 Department of Diagnostic Imaging and Nuclear
Medicine, Graduate School of Medicine, Kyoto University, Kyoto,
Japan
Background and Aim In transcatheter arterial chemoembolization
(TACE) for hepatocellular carcinoma (HCC), it has not been
clarified which chemotherapy agent is an effective combined
drug with lipiodol. We previously showed that lipiodol-TACE
combined with cisplatin (Cis-TACE) provided a higher response
rate than lipiodol-TACE combined with epirubicin (Epi-TACE)
for multiple HCC in a retrospective cohort study (Hepatol Res.
2011). We conducted a randomized controlled study comparing
the effectiveness of Epi-TACE and Cis-TACE. Method
Sixty patients with multiple HCC which were not indicated for
curative liver resection or percutaneous ablation therapy were
randomly assigned to Epi-TACE or Cis-TACE group, stratified
by the primary or non-primary treatment and the presence or
absence of the history of liver resection. Finally, 26 patients for
Epi-TACE group and 27 patients for Cis-TACE group met the
eligibility criteria and were analyzed. The primary endpoint
was response rate, and the secondary endpoints were progression
free survival (PFS) and overall survival (OS). Results
Patient characteristics were almost comparable between the
two groups, except for larger tumor size in Epi-TACE group.
The response rates were 42.3% for Epi-TACE group and
18.5% for Cis-TACE group (p = 0.057). When adjusted by
tumor size, the odds ratio for Epi-TACE group against Cis-TACE
group was 3.47 [95% confidence interval (CI): 0.98-13.6, p =
0.054]. The median PFS times were 224.5 days for Epi-TACE
group and 165 days for Cis-TACE group [hazard ratio (HR) for
Epi-TACE group against Cis-TACE group: 0.83, 95% CI: 0.47-
1.45, p = 0.503], and the median OS times were 1128 days
403
Overexpression of periostin is related to poor prognosis
of hepatocellular carcinoma
Se Young Jang 1 , Soo Young Park 1 , Won Young Tak 1 , Young Oh
Kweon 1 , Keun Hur 2 , Gyeonghwa Kim 2 , Yong-Hun Choi 2 , Jung Gil
Park 3 , Yu Rim Lee 1 , Sun Kyung Jang 1 , Su Hyun Lee 1 ; 1 Kyungpook
National University Hospital, Daegu, Korea (the Republic of); 2 Biochemistry
and Cell Biology, Kyungpook National University School
of Medicine, Daegu, Korea (the Republic of); 3 Gastroenterology
and Hepatology, CHA University, Gumi CHA medical center,
Gumi, Korea (the Republic of)
Background: Periostin is an extracellular matrix protein and
known to be related to the metastatic potential and prognosis
of human cancers in recent studies. However, few studies
showed the expression level of periostin and its association
with prognosis of hepatocellular carcinoma (HCC). We analyzed
periostin overexpression and its implication for prognosis
of HCC. Methods: A total of 149 patients who underwent
surgical resection in Kyungpook National University Hospital
between 2006 and 2010 were selected and retrospectively
reviewed. All tissue specimens were formalin-fixed and paraffin-embedded
for immunohistochemistry staining. A tissue
microarray (TMA) containing tissue from HCC (n=149), adjacent
non-tumor tissues of HCC. Results: Expression of periostin
was associated with microvascular invasion (OR=3.383;
p=0.001), multiple tumors (OR=2.631; p=0.020), and higher
modified UICC stage (OR=2.945, p=0.004). The patients with
positive periostin expression have significantly shorter overall
survival (p=0.021) and recurrence-free survival (p=0.032).
Cumulative overall survival was significantly different between
periostin negative and positive groups when microvascular
invasion was absent (p=0.018). Conclusion: We found that
high periostin expression on hepatocellular carcinoma tissues is
correlated with poor prognosis. Especially when microvascular
invasion is absent, periostin can be a better prognostic marker
for overall survival.