studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 433A
444
Hepatic function and tumour burden are predictive
of outcome in patients with hepatocellular carcinoma
treated with transarterial chemoembolisation
Martha Kirstein 1,2 , Nora Schweitzer 1,2 , Nazli Ay 1,2 , Christina
Boeck 1,2 , Bernhard Meyer 1,3 , Thomas Rodt 1,3 , Wacker Frank 1,3 ,
Michael P. Manns 1,2 , Arndt Vogel 1,2 ; 1 Medical School Hannover,
Hannover, Germany; 2 Gastroenterology, Hepatology, Endocrinology,
Hannover, Germany; 3 Radiology, Hannover, Germany
Background: Hepatocellular carcinoma (HCC) is one of the
most lethal and prevalent cancers worldwide. Transarterial
chemoembolization (TACE) is commonly used to act locally in
the intermediate disease stage. Early randomized trials and
more recent reviews and meta-analyses reported improved survival
rates of patients with unresectable lesions managed with
TACE so that TACE has been accepted as the standard treatment
for intermediate stage disease. Methods: In this study,
we characterized 487 HCC patients from Hannover Medical
School, Germany, treated with TACE and evaluated the
asscociation of their characteristics with survival. Results: 487
HCC patients were treated at least once with TACE between
2000 and 2013. Most patients (91.4%) were treated with conventional
TACE using doxorubicin, ciplatin and/or mitomycin
and lipiodol either alone or in combination with degradable
starch microspheres (DSM, Spherex). Only minorities received
transarterial embolisation (3.5%), transarterial chemoperfusion
(3.1%) or TACE with drug-eluting beads (1.6%) as first transarterial
treatment. 387 patients (79.3%) received TACE as first
HCC-specific therapy. The mean number of received TACEs
for all patients was 2.24±1.95(1-17) with a mean interval of
140±257(33-2376) days between the first and second TACE.
19.7%, 11.3% and 9% of the patients were diagnosed with
one, two and three HCC nodules, respectively, whereas the
remaining patients were diagnosed with more than three nodules.
The mean diameter of the largest lesion was 59±36mm
(4-226). 28.9% of the patients had at least one lesion ≥70mm.
Hepatic function was well preserved in most patients with a
mean Child-Pugh-Score A (6 points) and ALBI grade 2. After
repeated TACEs there was no significant decrease of liver
function observed as assessed by both classification systems.
However, values of cholinesterase (CHE) were significantly
decreased indicating CHE as a sensitive marker for patients
treated with TACE (p