studies

446A AASLD ABSTRACTS HEPATOLOGY, October, 2015
6% and 1% patients, respectively. In explant analysis, tumor
was uninodular in 45% and moderately differentiated in the
majority of cases (66%). Median HCC size was 28mm. Vascular
invasion and satellite nodules were observed in 24.5%
and 25% of patients, respectively. In 818 patients that survived
beyond the immediate post-transplant period, mean follow-up
was 27,7 months (±23,8), an overall survival was 70% in 5
years. Recurrence occurred in 8/818 (8%) cases, at a mean
time of 15 months (1.5-76m). Sites of recurrence were 40% in
liver, extrahepatic in 46% and both hepatic and extrahepatic
in 14%. Vascular invasion and alpha-fetoprotein (AFP) level
before liver transplantation were risk factors for tumor recurrence.
The presence of HCC recurrence was directly related
to poor survival. Female gender, need for re-transplantation,
vascular invasion and explant outside the Milan criteria were
also predictors of poor survival. Conclusion: Liver transplantation
for hepatocellular carcinoma in Brazil was associated with
an overall survival of 70% in 5 years. HCC recurrence ocurred
in 8% of patients. The presence of vascular invasion and AFP
before liver transplantation were associated with increased
risk of tumor recurrence. Female, vascular invasion, explant
outside the Milan criteria and HCC recurrence were related to
poor survival.
Disclosures:
The following authors have nothing to disclose: Aline Chagas, Luciana Kikuchi,
Guilherme Felga, Angelo A. Mattos, Renato F. Silva, Rita de Cássia M. da Silva,
Fernanda Branco, Marcio D. Almeida, Ilka F. Boin, José H. Garcia, Luiz C. D’Albuquerque,
Flair J. Carrilho
470
MESIAH score is an effective subclassification tool in
Barcelona Clinic Liver Cancer stage B: comparison with
other proposed methods
Jeong-Ju Yoo 1 , Su Jong Yu 1 , Eun Ju Cho 1 , Jeong-Hoon Lee 1 , June
Sung Lee 2 , 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, Inje University
College of Medicine, Goyang, Korea (the Republic of)
Background: The intermediate stage of hepatocellular carcinoma
(HCC) is a highly heterogeneous population, therefore
many models to predict survival of patients has been proposed.
The aim of this study is to evaluate the prognostic performance
in intermediate HCC among four models; Model to Estimate
Survival in Ambulatory Patient (MESIAH), original Barcelona
Clinic Liver Cancer (BCLC) B subclassification, modified model
A and modified model B. Methods: From January 2005 to
December 2006, a total of 1184 HCC patients who initially
treated with TACE were enrolled. Among them, 235 (19.8%)
patients were classified as BCLC stage B. Four subclassification
systems were tested; MESIAH, original BCLC B subclassification
(B1, B2, B3, B4), modified model A (B1, B2, B3+B4), and
modified model B (B1, B2+B3, B4). The predictive accuracies
of the four systems were compared based on c-statistic (c-index)
together with its confidence interval (CI). Results: Patients in
the cohort had a median age of 57 years and 80.9% were
men. 81.7% had a Child–Pugh class A and Hepatitis B virus
infection was present in 71.1% and the median overall survival
was 57.8 months. The MESIAH score had a highest degree
of discrimination, with a C-statistic of 0.617 [95% confidence
interval (CI), 0.564–0.670, hazard ratio 2.06 (1.72-2.48),
p