studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 421A
the 11th thoracic vertebral level. We performed univariate and
conditional inference tree analysis to identify the morphomic
characteristics predictive of survival. Our primary outcome was
actuarial survival at one year. We performed validation with
patients who underwent TACE at two other centers (University
of Michigan [n=85] and University of Texas Southwestern
[n=72].) In total 76 patients (74 male; 2 female) were identified
from the derivation cohort. Baseline characteristics, liver
function and tumor stage are shown in the Table. Median survival
was 564 days (95% CI: 416-713) from performance of
the CT scan. Conditional inference tree analysis revealed that
interstitial density (ITHU) was the only morphomic factor predictive
of survival. Patients with ITHU above 0.709 had a 1-year
survival of 51% (95% CI 43-59%) and those below 0.709 had
a 1-year survival of 87% (95% CI: 81-93%) (p=0.001). External
validation in two diverse external cohorts, showed that the
ITHU cutoff was also predictive of one year survival in patients
undergoing TACE at each site. In an exploratory analysis of the
derivation cohort, we found that patients who had decompensation
after TACE had a significantly higher ITHU than those
who did not (p3 and FBG≥2.68g/L
were independent risk factors of recurrence of HCC after LT.
A scoring model was built to predict the risk of tumor recurrence,
with a sensitivity of 68.3% and a specificity of 87.5%.
Conclusion: Pretransplant elevated plasma fibrinogen level significantly
increases the risk for tumor recurrence in patients
after liver transplantation for HCC. The scoring model we built
based on fibrinogen level and tumor number strongly correlates
with tumor recurrence and may aid in the selection of patients
that would most benefit from transplantation for HCC.
Disclosures:
The following authors have nothing to disclose: Guo-Ying Wang, Yang Yang,
Gui-Hua Chen
420
Racial Disparity in Hepatocellular Carcinoma Patients
Diagnosed in an Urban Medical Center
Kirthi Lilley, Paul H. Naylor, Omar Sadiq, Sarah Stern, Sindhuri
Benjaram, Karthik Ravindran, Samran Haider, Ryan Morton, Ravi
Anand, Anupama Devara, Karan Mathur, Philip A. Philip, Murray
N. Ehrinpreis, Milton G. Mutchnick; Internal Medicine, Wayne
State University School of Medicine, Detroit, MI
Background: Hepatocellular carcinoma (HCC) is a significant
liver disease outcome and based on a previous report from
our group, occurs in 23% of untreated African Americans (AA)
with chronic hepatitis C (CHC) who were followed for an average
of 8 years in an urban GI clinic. The aim of this study was
to evaluate racial disparity with respect to the role of CHC and
the development of HCC. Tumor size at first diagnosis and the
role of surveillance prior to diagnosis of HCC were the primary
foci of the study. Methods: The electronic medical records of
the largest health care provider in Southeast Michigan and
its associated multi-specialty group were used to identify all
patients with HCC between 2012 and 2014. Using ICD-9
codes 115.0 (hepatocellular carcinoma) and 115.2 (malignant
neoplasm of liver, NOS), a patient pool of 281 potential
HCC patients (67% AA) was identified. From the pool, 125
patients were confirmed to have HCC by imaging (US /CT/
MRI) and/or biopsy. The remaining patients either had metastastic
tumors or no confirmation of a HCC diagnosis. Race was
determined by self-reporting, based primarily on skin color and
was analyzed as AA (black) or Non-AA (non-black; Caucasian,
Hispanic, Asian and other) Results: The 125 confirmed
HCC patients were primarily AA (76%) and male (80%). The
average age at diagnosis of HCC was 62 years (range for
95% was 61-64 years). HCV was a dominant risk factor for
the development of HCC in AA but not in non-AA (89% vs
45%; p