studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 451A
480
Value of PIVKA II and AFP serum level kinetics for treatment
monitoring in patients with hepatocellular carcinoma
(HCC): a French pilot study
Audrey Payance 1 , Mohamed Bouattour 1 , Mohamed Achahboun 2 ,
Miguel Albuquerque 2 , Laurent Castera 1 , Pierre Bedossa 2 , Olivier
Soubrane 3 , Francois Durand 1 , Valerie Paradis 2 ; 1 HEPATOLOGY,
BEAUJON HOSPITAL, Clichy, France; 2 Pathology, BEAUJON
HOSPITAL, Clichy, France; 3 HPB Surgery and Liver Transplan,
BEAUJON HOSPITAL, Clichy, France
Background and Aims: In Asia, prothrombin induced by vitamin
K absence-II (PIVKA-II) is largely used as a diagnostic and
prognostic biomarker for hepatocellular carcinoma (HCC).
We already confirmed the diagnostic value of PIVKA-II for
European patients with early HCC. Herein, our aim was to
study the dynamics of PIVKA-II serum level in the follow-up of
European patients with HCC, according to treatment monitoring.
Material and Methods: Patients with histologically proven
HCC diagnosed in our center from January 2013 to August
2014 were included. For each patient, serum PIVKA-II and
afetoprotein (AFP) levels were assessed with an enzyme-linked
immunosorbent assay at two different times. We defined two
groups of patients: 1) “treated patients” group with first serum
sample obtained within two months before treatment (D0) and
the second within 2-3 months after treatment initiation (M2-3),
2) “non-treated patients” as a control group, with two serum
samples, at diagnosis (T1) and 2-3 months subsequently (T2).
Baseline serum levels of AFP and PIVKA-II and dynamics during
follow-up were compared between the two groups. Results are
presented as median (interquartile range). Results: A total of
32 patients with HCC developed on chronic liver disease were
included (men, 85 %; median age, 59 years; BCLC stage: A
47% - B 28%- C 19% - D 6%). Aetiologies of underlying liver
disease were alcohol consumption, viral hepatitis B, viral hepatitis
C, non alcoholic steato-hepatitis and genetic hemochromatosis
in 14 (44%) ; 8 (25%), 13 (41%), 4 (12%), 2 (6%) of
patients respectively. In 23 patients, HCC treatment was performed
including chemoembolization (n=14), radiofrequency
ablation (n=3), surgical resection (n=1), sorafenib (n=4), and
radioembolisation (n=1). For all patients, median baseline AFP
and PIVKA II serum levels were 11.6 ng/ml (4.8 - 139.8 ng/
ml) and 416 mAU/ml (100.5 - 5894.25 mAU/ml), respectively.
In the “treated patients” group, PIVKA II serum levels
decreased statistically significantly from D0 to M2-3 (D0: 811
mAU/ml (100.5-11559.75) vs M2-3: 292 mAU/ml (46.25
- 7391); p = 0.031)). However, no significant decrease was
observed regarding AFP serum levels between D0 and M2-3
(D0: 18.9 ng/ml (4.8-392) vs M2-3: 16.3 ng/ml (4.5-103);
p=0.831). Finally, no changes of AFP and PIVKA II serum levels
from baseline T1 to T2 were observed in the control group.
Conclusions: Significant decrease of PIVKA II serum levels following
treatment of HCC was observed. These results suggest
that this biomarker, in contrast to AFP, could be useful for monitoring
treatment in patients with HCC. Further investigations are
needed to validate these results.
Disclosures:
Mohamed Bouattour - Advisory Committees or Review Panels: Bayer Schering
Pharma; Speaking and Teaching: Bayer Schering Pharma
Laurent Castera - Speaking and Teaching: Gilead, BMS, Janssen, Echosens,
Abbvie, Biopredictive
Francois Durand - Advisory Committees or Review Panels: Astellas, Novartis,
BMS; Speaking and Teaching: Gilead
The following authors have nothing to disclose: Audrey Payance, Mohamed
Achahboun, Miguel Albuquerque, Pierre Bedossa, Olivier Soubrane, Valerie
Paradis
481
Liver-directed (LD) Therapy for Intermediate Stage
Hepatocellular Carcinoma: Survival Across Treatment
Strategies
Alvaro E. Castillo 1 , Willscott E. Naugler 2 , Kenneth J. Kolbeck 3 ,
Khashayar Farsad 3 , Susan L. Orloff 1 , Kevin Billingsley 4 , C. Kristian
Enestvedt 1 ; 1 Surgery, Oregon Health and Science University,
Portland, OR; 2 Internal Medicine, Oregon Health and Science
University, Portland, OR; 3 Dotter Interventional Institute, Oregon
Health and Science University, Portland, OR; 4 Division of Surgical
Oncology, Oregon Health and Science University, Portland, OR
Treatment strategies favor LD options for BCLC intermediate
stage HCC. Evaluate the outcomes of different multidisciplinary
treatment strategies in BCLC B patients. A retrospective cohort
analysis of HCC patients referred to our institutional Multidisciplinary
Liver Tumor Board. All with Barcelona Clinic Liver
Cancer (BCLC) stage B who underwent either trans-arterial
chemoembolization (TACE), radiation therapy (XRT)/TACE,
Yttrium-90 (Y-90) alone and Y-90/TACE were selected. Resection,
ablation or transplantation was excluded. Univariate analysis
was used to compare demographics, tumor characteristics,
and treatment modalities. Multivariate analysis of clinical factors
associated with survival was performed using Cox proportional
hazards modeling. Survival was compared using the
Kaplan Meier log-rank method. Eighty eight BCLC B patients
were included. Comparison by treatment groups showed
no difference in severity of disease or demographics except
for bilirubin which was higher for the TACE and TACE/XRT
groups when compared to Y-90 and Y-90/TACE (p=0.024).
Those who received Y-90 had larger tumors (median 6.5 cm,
p=