studies

434A AASLD ABSTRACTS HEPATOLOGY, October, 2015
Overall survival after the diagnosis of HCC according to the HCV
genotype.
Disclosures:
Raoel Maan - Consulting: AbbVie
Adriaan J. van der Meer - Consulting: Gilead; Speaking and Teaching: MSD,
Gilead
Jordan J. Feld - Advisory Committees or Review Panels: Merck, Janssen, Gilead,
AbbVie, Theravance, Bristol Meiers Squibb; Grant/Research Support: AbbVie,
Boehringer Ingelheim, Janssen, Gilead, Merck
Heiner Wedemeyer - Advisory Committees or Review Panels: Transgene, MSD,
Roche, Gilead, Abbott, BMS, Falk, Abbvie, Novartis, GSK, Roche Diagnostics;
Grant/Research Support: MSD, Novartis, Gilead, Roche, Abbott, Roche Diagnostics;
Speaking and Teaching: BMS, MSD, Novartis, ITF, Abbvie, Gilead
Jean-Francois Dufour - Advisory Committees or Review Panels: Bayer, BMS, Gilead,
AbbVie, Novartis, Sillagen, Genfit
Andres Duarte-Rojo - Advisory Committees or Review Panels: Gilead Sciences;
Grant/Research Support: Vital Therapies; Speaking and Teaching: Roche
Michael P. Manns - Consulting: Roche, BMS, Gilead, Boehringer Ingelheim,
Novartis, Idenix, Achillion, GSK, Merck/MSD, Janssen, Medgenics; Grant/
Research Support: Merck/MSD, Roche, Gilead, Novartis, Boehringer Ingelheim,
BMS; Speaking and Teaching: Merck/MSD, Roche, BMS, Gilead, Janssen, GSK,
Novartis
Stefan Zeuzem - Consulting: Abbvie, Bristol-Myers Squibb Co., Gilead, Merck
& Co., Janssen
Harry L. Janssen - Consulting: AbbVie, Bristol Myers Squibb, GSK, Gilead Sciences,
Innogenetics, Merck, Medtronic, Novartis, Roche, Janssen, Medimmune,
ISIS Pharmaceuticals, Tekmira; Grant/Research Support: AbbVie, Bristol Myers
Squibb, Gilead Sciences, Innogenetics, Merck, Medtronic, Novartis, Roche,
Janssen, Medimmune
Bart J. Veldt - Board Membership: GSK, Janssen Therapeutics
Robert J. de Knegt - Advisory Committees or Review Panels: Roche, Norgine,
Janssen Cilag, AbbVie; Grant/Research Support: Roche, Janssen Cilag, BMS,
AbbVie; Speaking and Teaching: Gilead, Roche, Janssen Cilag, AbbVie
The following authors have nothing to disclose: Frank Lammert, Bettina E. Hansen
446
Validation of the Metroticket calculator in liver transplant
recipients that had a prior chemoembolization for
hepatocellular carcinoma
Hyung-Don Kim 1 , Ju Hyun Shim 2 , Seungbong Han 3 , Mi-Jung Jun 2 ,
Yeonjung Ha 2 , Jihyun An 2 , Danbi Lee 2 , Kang Mo Kim 2 , Young-
Suk Lim 2 , Han Chu Lee 2 , Young-Hwa Chung 2 , Yung Sang Lee 2 ,
Dong Jin Suh 4 ; 1 Department of Internal Medicine, Asan Medical
Center, University of Ulsan College of Medicine, Seoul, Korea
(the Republic of); 2 Department of Gastroenterology, Asan Medical
Center, University of Ulsan College of Medicine, Seoul, Korea (the
Republic of); 3 Department of Applied statistics, Gachon University,
Gyeonggi-do, Korea (the Republic of); 4 Department of Internal
Medicine, Vievis Namuh Hospital, Seoul, Korea (the Republic of)
Background & Aims: The Metroticket calculator provides a continuum
of survival probabilities for transplanted hepatocellular
carcinoma (HCC) patients on the basis of tumor number, largest
tumor diameter, and presence of microvascular invasion
(MVI). This method had not yet been validated however in HCC
patients with a previous history of transarterial chemoembolization
(TACE). We performed this validation in our current study
in liver transplant (LT) recipients. Methods: We enrolled 142
patients with arterial enhancing HCC(s) on dynamic images
treated with TACE between 1997 and 2011 at Asan Medical
Center who were subsequent LT recipients. Tumor parameters
measured by the enhancement radiological method pre-LT
or by explant pathology post-LT were incorporated into the
Metroticket calculator. The calculator was validated in terms
of calibration and discrimination capacities for the entire study
population and for subgroups undergoing living donor-related
LT and infected with hepatitis B virus. Results: Study subjects
received a median of 2 TACE sessions (range, 1-18) prior to
LT, and most of these patients received a living donor graft
(97.2%) and had HBV infection (89.4%). Through images and
explants, 121 (85.2%) and 102 (71.8%) of our study subjects
met the Milan criteria, respectively. Seventeen patients
(12%) had no pathologic viable nodule, and 15 (10.6%) cases
showed microvascular invasion. The mean 3-year and 5-year
survival rates predicted by the radiological model for all 142
patients were 76.4% and 70.1%, respectively, and fell perfectly
within the 95% confidence intervals (CI) of the observed
estimates (72.8-86.2% and 68.6-83.2%, respectively). In the
pathological model incorporating microvascular invasion, the
anticipated 5 year survival rate of 120 patients with viable
nodules on explants was 69.5%, which also was inside the
95% CI of the actuarial rates (67.9-83.5%). The c-index as a
measure of discriminatory power was 0.61 and 0.62, respectively,
for the 3- and 5-year predictions in the radiological
model, and 0.72 for the 5-year prediction in the pathological
model. All corresponding findings were comparable for
subgroups of living donor-LT recipients and hepatitis B virus
infected patients. Conclusion: A Metroticket calculation based
on explant data can accurately predict post-LT survival in HCC
patients with prior TACE. Estimate-based predictions before LT
using imaging may have poorer discriminatory power compared
to calibration.
Disclosures:
Young-Suk Lim - Advisory Committees or Review Panels: Bayer Healthcare, Gilead
Sciences; Grant/Research Support: Bayer Healthcare, BMS, Gilead Sciences,
Novartis
Han Chu Lee - Grant/Research Support: Medigen Biotechnology Co., Novartis,
Roche, Bayer HealthCare, Bristol-Myers Squibb, INC research, Boehringer Ingelheim,
Taiho Pharmaceutical Co., Yuhan Co.
The following authors have nothing to disclose: Hyung-Don Kim, Ju Hyun Shim,
Seungbong Han, Mi-Jung Jun, Yeonjung Ha, Jihyun An, Danbi Lee, Kang Mo
Kim, Young-Hwa Chung, Yung Sang Lee, Dong Jin Suh
447
Retreatment with TACE: Transition of Model to Estimate
Survival in Ambulatory Hepatocellular carcinoma
patients helps decision
Young Youn Cho 1 , Su Jong Yu 1 , June Sung Lee 2 , Jeong-Ju Yoo 1 ,
Minjong Lee 1 , Donghyeon Lee 1 , Yuri Cho 1 , Eun Ju Cho 1 , Jeong-
Hoon Lee 1 , Yoon Jun Kim 1 , Jung-Hwan Yoon 1 ; 1 Department of
Internal Medicine and Liver Research Institute, Seoul National
University College of Medicine, Seoul, Korea (the Republic of);
2 Department of Internal Medicine, Ilsan Paik Hospital, Ilsan, Korea
(the Republic of)
Background/Aims: Transarterial chemoembolization (TACE) is
a major therapeutic modality for patients with unresectable
hepatocellular carcinoma (HCC), but prognosis is variable.
Model to Estimate Survival in Ambulatory Hepatocellular carcinoma
patients (MESIAH) was recently developed and validated
as a survival model to predict prognosis of patients with
HCC. We aimed to develop a novel index using MESIAH for
predicting who can benefit from repeated TACE. Methods: