studies

422A AASLD ABSTRACTS HEPATOLOGY, October, 2015
the majority of patients were not diagnosed in a surveillance
protocol. The majority of patients undergoing surveillance also
had non-curable tumors at diagnosis. The optimal method for
preventing HCC in AA remains effective treatment with the new
anti-viral therapies which, unlike previous therapies are highly
effective in AA.
Disclosures:
Milton G. Mutchnick - Advisory Committees or Review Panels: BMS; Grant/
Research Support: Janssen, Gilead; Speaking and Teaching: Janssen, Gilead,
Abbvie, CLDF, Simply Speaking
The following authors have nothing to disclose: 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
421
In patients with HCC and macrovascular invasion
treated with sorafenib, AFP value≤1000 UI/L at baseline
and vascular invasion not including 1 st order
branches or main trunk (Vp1/2) are associated with
prolonged survival.
Charlotte E. Costentin 1 , Françoise Roudot-Thoraval 2 , Thomas
Decaens 3 , Nathalie Ganne-Carrié 4 , Bernard Paule 5 , Eric Vibert 5 ,
Mélanie Chiaradia 6 , Christian Letoublon 7 , Julien Calderaro 8 , Giuliana
Amaddeo 1 , Alexis Laurent 9 , Ivan Bricault 10 , Olivier Seror 11 ,
Didier Samuel 5 , Ariane Mallat 1 , Christophe Duvoux 1 ; 1 Hepatology,
Hôpital Henri Mondor, Creteil, France; 2 Public Health, Henri
Mondor Hospital, Creteil, France; 3 Hepato-gastroenterology, CHU
Grenoble, Grenoble, France; 4 Hospital, Jean Verdier, Bondy,
France; 5 Hepatology-hepatobiliary surgery, Paul Brousse Hospital,
Villejuif, France; 6 Radiology, Henri Mondor Hospital, Creteil,
France; 7 Surgery, CHU Grenoble, Grenoble, France; 8 Pathology,
Henri mondor Hospital, Creteil, France; 9 Surgery, Henri Mondor
Hospital, Creteil, France; 10 Radiology, CHU Grenoble, Grenoble,
France; 11 Radiology, Jean Verdier Hospital, Bondy, France
Introduction: According to EASL-OERTC guidelines, sorafenib
is the standard of care for advanced hepatocellular carcinoma
(HCC) BCLC-C although in the SHARP trial, macrovascular
invasion (MVI) was associated with a poor prognosis. However,
survival had been assessed for patients with MVI with
or without extrahepatic spread (EHS) (8 months) but not in
the group of patients with MVI but no EHS. The aim of this
study was to describe outcome and predictors of survival
in patients with HCC and MVI but no extra-hepatic spread
treated with sorafenib. Methods: 67 patients with HCC and
MVI but no EHS treated with sorafenib were identified in the
database of 4 French centers (Bondy, Créteil, Grenoble,Villejuif)
and retrospectively studied. Results: Patients (pts) were
mostly males (88.1%), mean age 65.5±9.6 with underlying
cirrhosis (89.4%). Etiology of liver disease was alcohol ±NASH
(38.8%), viral hepatitis (35.8%), NASH without alcohol
(14.9%), other (10.4%). Child-Pugh score was A and B in 59
(86.4%) and 8 (13.6%) pts, respectively. HCC was uni-nodular
in 17 pts (25.4%), infiltrative in 32 pts (47.8%), bilobar
in 22 pts (33.3%). Median size of the larger nodule was 70
[50-100] mm. MVI distribution was: Vp1+2 (invasion of or
distal to the 2 nd order branches of the portal vein (PV)) in 8
pts (12.0%), Vp3 (invasion of 1 st order branches of the PV)
in 20 pts (30%), Vp4 (invasion of the main trunk and/or contra-lateral
PV branch) in 32 pts (47.5%) and hepatic vein±Vp
in 7 pts (10.5%). Median AFP level at baseline was 408 [32-
2695] ng/ml. Median follow up was 6.7 [4.0-15.1] months.
Median treatment duration on sorafenib was 6.4 months, and
20 (30%) pts had additional therapies during follow up, either
during sorafenib therapy or as second line (including TACE,
systemic therapy, radiotherapy or radioembolization). Median
overall survival was 12.6 months (IC95%: 8.4-16.7). In univariate
analysis, AFP>1000 UI/L and 1 st order branches/troncular
portal vascular invasion (Vp3-Vp4) were negatively associated
with survival (p=0.049 and 0.031 respectively). In multivariate
analysis, both parameters were independently associated
with death: AFP>1000 (HR 2.188 [1.09-4.41], p=0.029),
Vp3-Vp4 (HR 2.874[1.19-6.94], p=0.019). Median overall
survival in pts with these 2 prognostic factors was 8.4 [4.2-
12.5] months vs 16.9 [11.6-22.2] months in pts with one or
none of these prognostic factors (p 1000
UI/L and Vp3-Vp4 MVI are independent predictors of reduced
survival. Long-term survival (median 16 months) was observed
in pts with one or none of these 2 prognostic factors.
Disclosures:
Françoise Roudot-Thoraval - Advisory Committees or Review Panels: Roche; Consulting:
LFB biomedicaments; Speaking and Teaching: gilead, Janssen, BMS,
Roche
Nathalie Ganne-Carrié - Advisory Committees or Review Panels: Roche; Speaking
and Teaching: BMS, Gilead, Bayer
Olivier Seror - Board Membership: Bayer Healthcare; Consulting: Olympus;
Speaking and Teaching: Angiodynamics
Didier Samuel - Consulting: Astellas, MSD, BMS, Roche, Novartis, Gilead, LFB,
Janssen-Cilag, Biotest, Abbvie
Christophe Duvoux - Advisory Committees or Review Panels: Novartis, Roche,
Novartis, Roche, Novartis, Roche, Novartis, Roche; Speaking and Teaching:
Astellas, Astellas, Astellas, Astellas
The following authors have nothing to disclose: Charlotte E. Costentin, Thomas
Decaens, Bernard Paule, Eric Vibert, Mélanie Chiaradia, Christian Letoublon,
Julien Calderaro, Giuliana Amaddeo, Alexis Laurent, Ivan Bricault, Ariane Mallat
422
Lamivudine vs. Entecavir for the newly diagnosed hepatitis
B-virus related Hepatocellular carcinoma
jung hee kim, Dong Hyun Sinn, Kyunga Kim, Geum-Youn Gwak,
Yong-Han Paik, Moon Seok Choi, Joon Hyeok Lee, Kwang Cheol
Koh, Seung Woon Paik; samsung medical center, Seoul, Korea
(the Republic of)
Antiviral therapy is a key element in the management of hepatitis
B virus (HBV)-related hepatocellelular carcinoma (HCC)
patients. However, little is known whether potent drug, entecavir,
is more effective than a less potent drug, lamivudine,
in reducing the risk of death, hepatic decompensation and
recurrence in HBV-related HCC. A retrospective cohort of 451
newly-diagnosed, HBV-related HCC patients without antiviral
therapy at diagnosis, and started antiviral therapy with either
entecavir (n = 249) or lamivudine (n=202) were enrolled.
Overall survival, new-onset hepatic decompensation (ascites,
variceal bleeding, hepatic encephalopathy), and recurrence
after curative therapy were compared. Baseline HBV DNA levels
were not diffference between two groups but rescue therapy
was more frequent in lamvudine group.(45% vs. 6.4%,
p