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MAC 2 binding protein gi for the prediction of posthepatectomy liver failure in hepatocellular carcinoma patients
Electronic Poster Abstracts
EP01B-076 MAC 2 BINDING PROTEIN GI FOR THE PREDICTION OF POSTHEPATECTOMY LIVER FAILURE IN HEPATOCELLULAR CARCINOMA PATIENTS Y. Okuda, K. Taura, Y. Ikeno, T. Nishio, G. Yamamoto, K. Tanabe, E. Hatano, T. Kaido, H. Okajima and S. Uemoto Department of Surgery, Graduate School of Medicine Kyoto University, Japan Introduction: Posthepatectomy liver failure (PHLF) is a serious postoperative state, and the precise prediction of PHLF is essential. Recently, Mac 2 binding protein Gi (M2BPGi) has been reported as a useful predictor of liver fibrosis. We aimed to evaluate the usefulness of M2BPGi in predicting PHLF in hepatocellular carcinoma (HCC) patients. Methods: We retrospectively collected and analyzed the data of liver function tests, fibrotic markers, shear wave velocity (SWV) by acoustic radiation force impulse imaging, and resection rate (RR) of 138 patients with HCC who underwent liver resection. M2BPGi values were measured using frozen serum samples. RR was calculated by computed tomography volumetry. PHLF was diagnosed based on the International Study Group of Liver Surgery definition. Results: PHLF gradeSB occurred in 19 patients (13.7%: grade B, n = 14; grade C, n = 5). The area under the receiver operating characteristic curve (AUROC) of M2BPGi, SWV and platelet count (Plt) in predicting PHLF gradeSB was high (0.705, 0.769 and 0.720, respectively). Multivariate analysis identified M2BPGi (odds ratio [OR]: 2.08, 95% confidence interval [CI]: 1.28 to 3.55, p < 0.01), Plt (OR: 0.39, 95% CI: 0.18 to 0.80, p = 0.02) and RR (OR: 2.71, 95% CI: 1.46 to 5.40, p < 0.01) as the significant factors associated with PHLF gradeSB, and the logistic model that included these factors resulted in an AUROC of 0.81. Conclusion: In HCC patients, M2BPGi was useful in predicting PHLF, and the predictive power was improved in combination with Plt and RR.
EP01B-077 SURVIVAL OUTCOMES AFTER HEPATIC RESECTION FOR HEPATOCELLULAR CARCINOMA AND COMPARISON OF THERAPEUTIC MODALITIES FOR RECURRED HEPATOCELLULAR CARCINOMA: A SINGLE CENTER EXPERIENCE FOR 10 YEARS H. S. Jang, C. K. Cho and Y. S. Koh Chonnam National University Hwasun Hospital, Republic of Korea Purpose: Surgical resection is undoubtedly the standard modality for resectable hepatocellular carcinoma (HCC). The aim of this study was to evaluate survival outcomes after surgery for HCC and to compare outcomes of various modality for recurrence.
HPB 2016, 18 (S1), e1ee384
e217
Methods: Between April 2004 and August 2013, data of 500 patients who underwent surgery for HCC at Chonnam National University Hwasun Hospital were reviewed. Results: Male was predominant (Male : Female = 85.6%: 14.4%) and Median age was 59.0. The mean follow-up of all patients was 39.4 (range, 1w111 months) months. The postoperative mortality rate was 2% (n = 10). Overal 1-, 3-, and 5-year survival rates were 94.1%, 84.1%, and 77.8%, respectively (mean survival time, 90.2 months). Diseasefree 1-, 3-, and 5-year survival rates were 69.1%, 46.6%, and 36.8%, respectively (mean survival time, 49.0 months). Recurrence was observed in 254 patients (50.8%) during observation period. 30 patients underwent repetitive resection for recurred HCC. Radiofrequency ablation (RFA), transarterial chemoembolization (TACE), and chemotherapy or radiotherapy were performed in 78, 111, and 22 patients, respectively. Overall 1-, 3-, and 5-year survival rates were 98.1%, 87.8%, and 83.6% (mean survival time, 96.4 months), in radical intended treatment (repetitive resection and RFA) group, 87.4%, 66.5%, and 53.8% (mean survival time, 66.0 months) in TACE and other treatment group, and, 69.2%, 18.5%, and 0% in notreatment group, respectively. Conclusions: Hepatic resection was a safe and effective therapeutic modality for HCC. Recurrence rate was high, however, survival rate could be improved with active and proper treatment for recurred HCC.
EP01B-078 EFFICACY OF COMBINATION THERAPY OF HEPATIC ARTERIAL INJECTION CHEMOTHERAPY WITH RADIOTHERAPY FOR UNRESECTABLE ADVANCED HEPATOCELLULAR CARCINOMA COMPLICATED BY MAJOR VASCULAR TUMOR THROMBOSIS J. Tani, H. Miyoshi and T. Masaki Gastroenterology and Neurology, Kagawa Medical University School of Medicine, Japan Introduction: HCC complicated by vascular tumor thrombosis is associated with poor prognosis. The aim of this study was to evaluate the clinical outcomes, and adverse effects of hepatic artery infusion chemotherapy (HAIC) for intrahepatic tumor combined with local radiotherapy in patients with advanced HCC complicated by vascular tumor thrombosis. Methods: Subjects were 26 patients with advanced HCC complicated by high-grade vascular invasion. HAIC consisted of cisplatin in lipiodol emulsion combined with 5-fluorouracil (5-FU). HAIC was continued as long as liver function and other conditions permitted. Radiotherapy was given at a total dose of 2 Gy on 25e28 occasions (total dose, 50e56 Gy). Results: The maximum responses to radiotherapy for vascular invasion as assessed by the m-RECIST criteria were CR in 8 patients, PR in 14, SD in 4, and PD in 0, giving a response rate of 84.6%. The maximum responses to the combination therapy for the entire tumor as assessed by the mRECIST criteria were CR in 1 patient, PR in16, SD in 6, and PD in 3, for a response rate of 65.3%. The median survival
EP01B-076 MAC 2 BINDING PROTEIN GI FOR THE PREDICTION OF POSTHEPATECTOMY LIVER FAILURE IN HEPATOCELLULAR CARCINOMA PATIENTS Y. Okuda, K. Taura, Y. Ikeno, T. Nishio, G. Yamamoto, K. Tanabe, E. Hatano, T. Kaido, H. Okajima and S. Uemoto Department of Surgery, Graduate School of Medicine Kyoto University, Japan Introduction: Posthepatectomy liver failure (PHLF) is a serious postoperative state, and the precise prediction of PHLF is essential. Recently, Mac 2 binding protein Gi (M2BPGi) has been reported as a useful predictor of liver fibrosis. We aimed to evaluate the usefulness of M2BPGi in predicting PHLF in hepatocellular carcinoma (HCC) patients. Methods: We retrospectively collected and analyzed the data of liver function tests, fibrotic markers, shear wave velocity (SWV) by acoustic radiation force impulse imaging, and resection rate (RR) of 138 patients with HCC who underwent liver resection. M2BPGi values were measured using frozen serum samples. RR was calculated by computed tomography volumetry. PHLF was diagnosed based on the International Study Group of Liver Surgery definition. Results: PHLF gradeSB occurred in 19 patients (13.7%: grade B, n = 14; grade C, n = 5). The area under the receiver operating characteristic curve (AUROC) of M2BPGi, SWV and platelet count (Plt) in predicting PHLF gradeSB was high (0.705, 0.769 and 0.720, respectively). Multivariate analysis identified M2BPGi (odds ratio [OR]: 2.08, 95% confidence interval [CI]: 1.28 to 3.55, p < 0.01), Plt (OR: 0.39, 95% CI: 0.18 to 0.80, p = 0.02) and RR (OR: 2.71, 95% CI: 1.46 to 5.40, p < 0.01) as the significant factors associated with PHLF gradeSB, and the logistic model that included these factors resulted in an AUROC of 0.81. Conclusion: In HCC patients, M2BPGi was useful in predicting PHLF, and the predictive power was improved in combination with Plt and RR.
EP01B-077 SURVIVAL OUTCOMES AFTER HEPATIC RESECTION FOR HEPATOCELLULAR CARCINOMA AND COMPARISON OF THERAPEUTIC MODALITIES FOR RECURRED HEPATOCELLULAR CARCINOMA: A SINGLE CENTER EXPERIENCE FOR 10 YEARS H. S. Jang, C. K. Cho and Y. S. Koh Chonnam National University Hwasun Hospital, Republic of Korea Purpose: Surgical resection is undoubtedly the standard modality for resectable hepatocellular carcinoma (HCC). The aim of this study was to evaluate survival outcomes after surgery for HCC and to compare outcomes of various modality for recurrence.
HPB 2016, 18 (S1), e1ee384
e217
Methods: Between April 2004 and August 2013, data of 500 patients who underwent surgery for HCC at Chonnam National University Hwasun Hospital were reviewed. Results: Male was predominant (Male : Female = 85.6%: 14.4%) and Median age was 59.0. The mean follow-up of all patients was 39.4 (range, 1w111 months) months. The postoperative mortality rate was 2% (n = 10). Overal 1-, 3-, and 5-year survival rates were 94.1%, 84.1%, and 77.8%, respectively (mean survival time, 90.2 months). Diseasefree 1-, 3-, and 5-year survival rates were 69.1%, 46.6%, and 36.8%, respectively (mean survival time, 49.0 months). Recurrence was observed in 254 patients (50.8%) during observation period. 30 patients underwent repetitive resection for recurred HCC. Radiofrequency ablation (RFA), transarterial chemoembolization (TACE), and chemotherapy or radiotherapy were performed in 78, 111, and 22 patients, respectively. Overall 1-, 3-, and 5-year survival rates were 98.1%, 87.8%, and 83.6% (mean survival time, 96.4 months), in radical intended treatment (repetitive resection and RFA) group, 87.4%, 66.5%, and 53.8% (mean survival time, 66.0 months) in TACE and other treatment group, and, 69.2%, 18.5%, and 0% in notreatment group, respectively. Conclusions: Hepatic resection was a safe and effective therapeutic modality for HCC. Recurrence rate was high, however, survival rate could be improved with active and proper treatment for recurred HCC.
EP01B-078 EFFICACY OF COMBINATION THERAPY OF HEPATIC ARTERIAL INJECTION CHEMOTHERAPY WITH RADIOTHERAPY FOR UNRESECTABLE ADVANCED HEPATOCELLULAR CARCINOMA COMPLICATED BY MAJOR VASCULAR TUMOR THROMBOSIS J. Tani, H. Miyoshi and T. Masaki Gastroenterology and Neurology, Kagawa Medical University School of Medicine, Japan Introduction: HCC complicated by vascular tumor thrombosis is associated with poor prognosis. The aim of this study was to evaluate the clinical outcomes, and adverse effects of hepatic artery infusion chemotherapy (HAIC) for intrahepatic tumor combined with local radiotherapy in patients with advanced HCC complicated by vascular tumor thrombosis. Methods: Subjects were 26 patients with advanced HCC complicated by high-grade vascular invasion. HAIC consisted of cisplatin in lipiodol emulsion combined with 5-fluorouracil (5-FU). HAIC was continued as long as liver function and other conditions permitted. Radiotherapy was given at a total dose of 2 Gy on 25e28 occasions (total dose, 50e56 Gy). Results: The maximum responses to radiotherapy for vascular invasion as assessed by the m-RECIST criteria were CR in 8 patients, PR in 14, SD in 4, and PD in 0, giving a response rate of 84.6%. The maximum responses to the combination therapy for the entire tumor as assessed by the mRECIST criteria were CR in 1 patient, PR in16, SD in 6, and PD in 3, for a response rate of 65.3%. The median survival