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Epidemiology of metastatic hepatocellular carcinoma in a rapidly growing community
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Electronic Poster Abstracts
Systematic Review was performed to find the best treatment options (surgery and/or chemotherapy and/or radiotherapy) and to determinate prognostic factors and overall survival (OS). Systematic review of articles published on PUBMED and MEDLINE (1966 to april/1/2015), with keywords: Primary liver sarcoma and Primary hepatic sarcoma. Adult patients (>18 years), articles in English, Portuguese and Spanish were included. Case reports, tumors of double origin (carcinosarcomas), metastastatic sarcomas and multiple diagnosis were excluded. Three authors researched individually and the senior author judged the inclusion of the pre-selected articles. After the research, 1273 articles were found, of those 1165 were excluded because they were clearly out of inclusion criteria. In the end were left 108 articles and, after reading all the abstracts, 11 were included. The most common histologic types were leiomyosarcoma, angiosarcoma and epithelioid hemangioendothelioma. Histologic type, differentiation degree and R0 resection were the most influent prognostic factors. The 5 year OS varied from 18% to 65%. Surgery (resection) is the main treatment of primary liver sarcomas. More effective systemic treatments need to be developed to improve the prognosis of this heterogeneous type of tumor.
EP01B-054 EPIDEMIOLOGY OF METASTATIC HEPATOCELLULAR CARCINOMA IN A RAPIDLY GROWING COMMUNITY A. Vijay1, K. Ahmed2, Y. Kamel3, H. Khalaf2, A. Elaffandy2, W. El Ansari1 and W. Elmoghazy2 1 Surgery, 2Surgery/Organ Transplant, and 3Gastroenterology and Hepatology, Hamad Medical Corporation, Qatar Introduction: Our community has grown rapidly over the last 4 years with increasing number of hepatocellular carcinoma (HCC) cases. The purpose of this study is to investigate characteristics of HCC patients and to identify predictors of metastatic tumors. Methods: It includes patients diagnosed with HCC between 2011 and 2015 in Qatar, other primary and secondary liver tumors were excluded. Data including patient and tumor characteristics, clinical and laboratory investigations were collected from medical records. Univariate analysis was done to identify potential predictors of metastatic HCC using Chi-square test and t-test. Multivariate logistic regression analysis was done to assess independent predictors of metastatic HCC. P-value of < 0.05 was considered significant. Results: A total of 180 patients were diagnosed with HCC, 47 of them (26%) developed metastases. There were 150 male patients, and mean age at time diagnosis was 58.8 10.5 years. Follow-up ranged from 0.1 to 4.3 years with a mean of 1.0 1.1 years. Single site metastasis was diagnosed in 10 patients while 37 patients had multiple sites metastases. Metastases included abdominal sites in 24 patients, thoracic in 13, bone in 7 and unusual sites in 3 patients. Potential predictors of metastatic HCC were multi-focal HCC, bilobar lesions, macro-vascular invasion, and tumor diameter >5cm.
Multivariate regression analysis showed that tumor diameter >5cm is independent predictor of metastatic HCC (OR = 3.411, 95% CI = 1.607e7.242) (P = 0.001). In conclusion, metastatic HCC is not rare, it represents 26% of our cohort and tumor >5 cm is associated with high risk of metastasis.
EP01B-055 LIVER RESECTION FOR HEPATOCELLULAR CARCINOMA O. Abbasoglu, E. Hamaloglu and O. Cennet Hacettepe University, Turkey Aim: Hepotocellular carcinoma (HCC) is the most common primary liver cancer. The aim of this study was to analyze our data on liver resection in 99 patients. Method: Between January 2000 and December 2014, 99 patients were operated on for HCC, at Hacettepe University (Ankara, Turkey). The hospital chats wre retrospectively analyzed. The median age of the patients was 66 (range: 17e82) and female to male ratio was 1/3. Viral hepatitis seropositivity was seen in 72 (73%) patients (HbsAg+ in 49 patients, HCV+ in 23 patients). Alfafetoprotein (AFP) level was above the normal limit in 70% of the cases. Tumor was localized in the right lobe in 62 patients and HCC was multinodular 15. Results: During operation 8 patients were found to be inoperable because of peritoneal carcinomatosis or diffuse disease. Of the patients, 45 underwent non-anatomical resection and 41 underwent anatomical resections (including 18 right hepatectomy, 10 left hepatectomy). In 12 patients radiofrequency ablation was combined with surgical resection. The median tumor size was 5.2 cm (range 1e15 cm), median lenght of hospital stay was 6 days (range: 3e61 days). Major complications including bile leaks and hemorrhage were seen in 14% and 30 day mortality rate was 5.2%. Five year actuarial survival rate was found to be 33%. Conclusion: Compared to series from other countries, the median tumor size of our patients was larger and HBsAg positivity and multinodular HCC patients were more common in the resection group. Despite characteristics, acceptable 5 year survival rate can be achieved.
EP01B-056 RARE TUMORS OF LIVER e EXPERIENCE OF TERTIARY CARE CENTRE S. Subramani, R. Vellaisamy, A. Anbalagan, B. Duraisamy, P. Raju, C. Servarayan Murugeasan and K. Devy Gounder Institute of Surgical Gastroenterology, Madras Medical College and Rajiv Gandhi Govt General Hospital, India Aim: The aim of this study is to analyze the clinical presentation, surgical management, outcome of uncommon liver tumors in a tertiary care center. Methods: This is a retrospective study design between January 2013 to August 2015. The study includes 17 patients. Male 11, female 6. The age group ranged between 13e74 years. The study excluded common indications like Primary hepatocellular carcinoma and Colorectal liver
HPB 2016, 18 (S1), e1ee384
Electronic Poster Abstracts
Systematic Review was performed to find the best treatment options (surgery and/or chemotherapy and/or radiotherapy) and to determinate prognostic factors and overall survival (OS). Systematic review of articles published on PUBMED and MEDLINE (1966 to april/1/2015), with keywords: Primary liver sarcoma and Primary hepatic sarcoma. Adult patients (>18 years), articles in English, Portuguese and Spanish were included. Case reports, tumors of double origin (carcinosarcomas), metastastatic sarcomas and multiple diagnosis were excluded. Three authors researched individually and the senior author judged the inclusion of the pre-selected articles. After the research, 1273 articles were found, of those 1165 were excluded because they were clearly out of inclusion criteria. In the end were left 108 articles and, after reading all the abstracts, 11 were included. The most common histologic types were leiomyosarcoma, angiosarcoma and epithelioid hemangioendothelioma. Histologic type, differentiation degree and R0 resection were the most influent prognostic factors. The 5 year OS varied from 18% to 65%. Surgery (resection) is the main treatment of primary liver sarcomas. More effective systemic treatments need to be developed to improve the prognosis of this heterogeneous type of tumor.
EP01B-054 EPIDEMIOLOGY OF METASTATIC HEPATOCELLULAR CARCINOMA IN A RAPIDLY GROWING COMMUNITY A. Vijay1, K. Ahmed2, Y. Kamel3, H. Khalaf2, A. Elaffandy2, W. El Ansari1 and W. Elmoghazy2 1 Surgery, 2Surgery/Organ Transplant, and 3Gastroenterology and Hepatology, Hamad Medical Corporation, Qatar Introduction: Our community has grown rapidly over the last 4 years with increasing number of hepatocellular carcinoma (HCC) cases. The purpose of this study is to investigate characteristics of HCC patients and to identify predictors of metastatic tumors. Methods: It includes patients diagnosed with HCC between 2011 and 2015 in Qatar, other primary and secondary liver tumors were excluded. Data including patient and tumor characteristics, clinical and laboratory investigations were collected from medical records. Univariate analysis was done to identify potential predictors of metastatic HCC using Chi-square test and t-test. Multivariate logistic regression analysis was done to assess independent predictors of metastatic HCC. P-value of < 0.05 was considered significant. Results: A total of 180 patients were diagnosed with HCC, 47 of them (26%) developed metastases. There were 150 male patients, and mean age at time diagnosis was 58.8 10.5 years. Follow-up ranged from 0.1 to 4.3 years with a mean of 1.0 1.1 years. Single site metastasis was diagnosed in 10 patients while 37 patients had multiple sites metastases. Metastases included abdominal sites in 24 patients, thoracic in 13, bone in 7 and unusual sites in 3 patients. Potential predictors of metastatic HCC were multi-focal HCC, bilobar lesions, macro-vascular invasion, and tumor diameter >5cm.
Multivariate regression analysis showed that tumor diameter >5cm is independent predictor of metastatic HCC (OR = 3.411, 95% CI = 1.607e7.242) (P = 0.001). In conclusion, metastatic HCC is not rare, it represents 26% of our cohort and tumor >5 cm is associated with high risk of metastasis.
EP01B-055 LIVER RESECTION FOR HEPATOCELLULAR CARCINOMA O. Abbasoglu, E. Hamaloglu and O. Cennet Hacettepe University, Turkey Aim: Hepotocellular carcinoma (HCC) is the most common primary liver cancer. The aim of this study was to analyze our data on liver resection in 99 patients. Method: Between January 2000 and December 2014, 99 patients were operated on for HCC, at Hacettepe University (Ankara, Turkey). The hospital chats wre retrospectively analyzed. The median age of the patients was 66 (range: 17e82) and female to male ratio was 1/3. Viral hepatitis seropositivity was seen in 72 (73%) patients (HbsAg+ in 49 patients, HCV+ in 23 patients). Alfafetoprotein (AFP) level was above the normal limit in 70% of the cases. Tumor was localized in the right lobe in 62 patients and HCC was multinodular 15. Results: During operation 8 patients were found to be inoperable because of peritoneal carcinomatosis or diffuse disease. Of the patients, 45 underwent non-anatomical resection and 41 underwent anatomical resections (including 18 right hepatectomy, 10 left hepatectomy). In 12 patients radiofrequency ablation was combined with surgical resection. The median tumor size was 5.2 cm (range 1e15 cm), median lenght of hospital stay was 6 days (range: 3e61 days). Major complications including bile leaks and hemorrhage were seen in 14% and 30 day mortality rate was 5.2%. Five year actuarial survival rate was found to be 33%. Conclusion: Compared to series from other countries, the median tumor size of our patients was larger and HBsAg positivity and multinodular HCC patients were more common in the resection group. Despite characteristics, acceptable 5 year survival rate can be achieved.
EP01B-056 RARE TUMORS OF LIVER e EXPERIENCE OF TERTIARY CARE CENTRE S. Subramani, R. Vellaisamy, A. Anbalagan, B. Duraisamy, P. Raju, C. Servarayan Murugeasan and K. Devy Gounder Institute of Surgical Gastroenterology, Madras Medical College and Rajiv Gandhi Govt General Hospital, India Aim: The aim of this study is to analyze the clinical presentation, surgical management, outcome of uncommon liver tumors in a tertiary care center. Methods: This is a retrospective study design between January 2013 to August 2015. The study includes 17 patients. Male 11, female 6. The age group ranged between 13e74 years. The study excluded common indications like Primary hepatocellular carcinoma and Colorectal liver
HPB 2016, 18 (S1), e1ee384