studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 455A
Patients characteristics
fatty liver disease. Overall, the percentage of non-cirrhotic,
non-HBV HCC was 2.93%, non-cirrhotic, non-HBV HCC with
hepatitis C was 1.66%, and non-cirrhotic, non-HBV HCC with
fatty liver disease was 6.6%. Conclusions Non-HBV HCC can
arise in the setting of chronic hepatitis C and fatty liver disease
without advanced fibrosis or cirrhosis. Our prevalence rates
may underestimate the true prevalence owing to the exclusion
of patients without adequate histology available.
Disclosures:
Steven-Huy B. Han - Grant/Research Support: Bristol Myers Squibb, Gilead
The following authors have nothing to disclose: Vivian Ng, Jennifer Phan, Alan
J. Sheinbaum
Disclosures:
Rene Adam - Grant/Research Support: Merck Serono, Roche, Sanofi aventis,
astellas, novartis, Merck Serono, Roche, Sanofi aventis, astellas, novartis, Merck
Serono, Roche, Sanofi aventis, astellas, novartis, Merck Serono, Roche, Sanofi
aventis, astellas, novartis
Didier Samuel - Consulting: Astellas, MSD, BMS, Roche, Novartis, Gilead, LFB,
Janssen-Cilag, Biotest, Abbvie
The following authors have nothing to disclose: Eleonora De Martin, Michel
Rayar, Damien Bergeat, Luis Filipe Abreu de Carvalho, Maximiliano Gelli, Denis
X. Castaing, Daniel Cherqui, Antonio Sa-Cunha, Emmanuel Boleslawski, Karim
Boudjema, Eric Vibert
488
Non-Cirrhotic Hepatocellular Carcinoma in the Absence
of Hepatitis B
Vivian Ng 1 , Jennifer Phan 1 , Alan J. Sheinbaum 2 , Steven-Huy B.
Han 1 ; 1 Pfleger Liver Institute, University of California, Los Angeles,
Los Angeles, CA; 2 Gastroenterology, VA West Los Angeles Healthcare
Center, Los Angeles, CA
Purpose Hepatocellular carcinoma (HCC) accounts for approximately
90% of primary hepatic malignancies worldwide.
In hepatitis B virus (HBV) infection, HCC can develop in the
absence of cirrhosis. However, it is thought that in chronic
hepatitis C virus infection and fatty liver disease, development
of cirrhosis is necessary prior to formation of HCC. To date,
there have only been a small number of case reports showing
that HCC can develop in patients with chronic hepatitis C and
in fatty liver disease without evidence of underlying cirrhosis.
We sought to evaluate whether or not non-cirrhotic HCC exists
and assess underlying risk factors contributing to its development.
Methods We performed a single-center, retrospective
chart review study at a large academic tertiary care hospital.
All patients seen in both the liver cancer clinic and orthotopic
liver transplantation (OLT) clinic for liver cancer in the last 10
years were evaluated. We determined how many patients
had non-cirrhotic HCC based on available pathology reports,
such as explanted liver pathology, liver resection pathology,
and liver biopsy pathology. Patients with hepatitis B, non-
HCC tumors, and patients without both tumor and non-tumor
liver histology available were excluded. Demographic information,
pertinent lab values, and co-morbid conditions were
recorded. Results 1925 unique patients were identified. 1382
patients were excluded from the study, including 303 patients
with hepatitis B, 510 patients with non-HCC tumors, and 569
patients without available tumor and non-tumor histology. Of
the remaining patients, 491 patients underwent (OLT), 70
underwent local ablative therapy, 42 underwent resection of
the HCC, and 17 underwent systemic therapy. All 491 OLT
patients had underlying cirrhosis. Of the 134 patients who
did not undergo (OLT), 35 patients (26.1%) were identified as
having non-cirrhotic HCC. 13 patients (37.1%) had an underlying
diagnosis of hepatitis C, and 6 patients (17.1%) had
489
Albi score predicts survival in patients with BCLC 0/A
stage Hepatocellular Carcinoma (HCC) independently of
Child Pugh (CP) score and treatment allocation
Simona Onali 1 , Aileen Marshall 1 , Dinesh Sharma 1 , Pam O’Donoghue
1 , Emily Dannhorn 1 , Phillip Johnson 2 , James O’Beirne 1 ;
1 Sheila Sherlock Liver Centre, Royal Free Hospital, London, United
Kingdom; 2 Department of Molecular and Clinical Cancer Medicine,
University of Liverpool, Liverpool, United Kingdom
Introduction: BCLC 0/A stage HCC patients are considered
candidates for curative treatments. Within the BCLC classification,
liver function is assessed by CP score despite this score
not being derived from patients with HCC. ALBI is a novel
evidence based score derived from a large cohort of HCC
patients and has been shown to define different prognostic
groups even within CP A. 1 We studied the performance of ALBI
score in a well characterised cohort of patients with BCLC 0/A
stage HCC to determine if ALBI score impacted on prognosis.
Methods: Consecutive patients with BCLC 0/A HCC, evaluated
between 2010-2014 at the Royal Free Hospital were included.
All patients had a performance score of 0 and were undergoing
evaluation for potential resection. Patients were considered
resectable if they had HVPG≤10mmHg or HVPG≥10mmHg
with good liver function as assessed by ICG clearance. ALBI
score was calculated at the time of HVPG and ICG clearance
measurement and divided into 3 grades as per published cutoffs.
Kaplan Meier and Cox regression analysis were used to
assess the impact of ALBI on survival. Results: 67 patients were
included: 64 (95.5%) were CP A, 3 (4.5%) were CP B. 60
(89%) had uninodular tumour and 7 (10.4%) multifocal (≤3
tumours ≤30mm). 46 (69%) underwent resection, 4 (6%) RFA,
9 (14%) TAE, 3 (5%) OLT, 3 (5%) either no treatment or undergoing
evaluation. Median follow up was 9 months (13-54).
10 (15%) patients died during follow up. Cause of death was
HCC-related n= 4, liver failure n=4, non-liver related n=2. In
Kaplan Meier analysis CP score was not associated with difference
in survival. Cox regression analysis revealed ALBI score as
the only significant factor related to survival and was independent
of CP score and treatment allocation (p=0.002, OR=15,
95%CI=3-80). Of patients with ALBI grade 1, 44 (83%) were
considered suitable and underwent resection vs only 2 (14%)
with ALBI 2. One-year survival was 88% in patients with ALBI
grade 1 and 43% in patients with ALBI grade 2 (p=0.002).
Conclusion: In patients with BCLC 0/A stage HCC ALBI score
clearly defines patients with different prognosis regardless
of Child Pugh score and treatment allocation. ALBI grade 2
patients are very rarely suitable candidates for resection. ALBI
score is more informative than Child Pugh score in patients with
early stage HCC and may be useful in determining treatment
allocation References: 1 . Johnson PJ et al. Assessment of Liver
Function in Patients With Hepatocellular Carcinoma: A New