studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 445A
and high major complications. Retreatment with TACE should
be avoided.
Figure 1. Overall survival analysis according to SMART
Disclosures:
Tawesak Tanwandee - Grant/Research Support: MSD, BMS, Fibrogen, Biotron,
Celcion
The following authors have nothing to disclose: Saharat Jarupongprapa, Supot
Nimanong, Siwaporn Chainuvati, Phunchai Charatcharoenwitthaya, Watcharasak
Chotiyaputta
468
Combination of modified Response Evaluation Criteria
in Solid Tumors and hand-foot-skin reaction: a new
prognostic evaluation for HCC patients treated with
sorafenib and transarterial chemoembolization
Wenjun Wang 1 , Yan Zhao 1 , Wei Bai 1 , Lei Liu 1 , Man Yang 1 , Hongwei
Cai 3 , Lei Zhang 1 , Zhanxin Yin 1 , Zhuoli Zhang 1 , Daiming
Fan 1 , Jielai Xia 2 , Guohong Han 1 ; 1 Xijing Hospital of Digestive
Diseases, Xijing Hospital, Fourth Military Medical University, Xi’an,
China; 2 Department of Medical Statistics, Fourth Military Medical
University, Xi’an, China; 3 Information Center, School of Stomatology,
Fourth Military Medical University, Xi’an, China
The aim of this study was to combine the modified Response
Evaluation Criteria in Solid Tumors (mRECIST) and hand-footskin
reaction (HFSR) to establish a new prognostic evaluation
for hepatocellular carcinoma (HCC) patients undergoing
sorafenib and transarterial chemoembolization (TACE). 176
consecutive intermediate-advanced HCC patients treated with
combination therapy were enrolled. The therapeutic responses
were assessed by mRECIST and HFSR criteria at 1, 2 and 3
months, respectively. Uni/multivariate Cox regressions were
used to investigate the earliest time when treatment responses
could be accurately assessed. Then according to the mRECIST
and HFSR assessed at that time, SMART (Sorafenib with Modified
RECIST Assessment plus hand-foot-skin Reaction in TACE)
prognostic evaluation was developed: SMART A, responders
on both assessments; SMART B, responders on either of assessment
and SMART C, non-responders on both assessments.
Moreover, we explore the prognostic value of SMART for
predicting overall survival(OS) in comparison with mRECIST
and HFSR about likelihood ratio, Akaike information criterion
(AIC) and C-index respectively. The earliest time at which the
responses of mRECIST and HFSR correlated with the survival
was 2 months after therapy. The SMART stratified patients with
three different prognosis; the SMART A had the longest median
OS, followed by SMART B and SMART C (30.5, 17.4, and
8.3 months, respectively; P