P969 ARTERIAL BLOOD SUPPLY OF HEPATOCELLULAR CARCINOMA IS ASSOCIATED WITH EFFICACY OF SORAFENIB THERAPY

POSTERS P968 COMPARISON OF CHEMOEMBOLIZATION AND HEPATIC RESECTION FOR LARGE SOLITARY HEPATOCELLULAR CARCINOMA: A PROPENSITY SCORE ANALYSIS Y.B. Lee1 , D.H. Lee1 , Y. Cho1 , S.J. Yu1 , J.-H. Lee1 , J.-H. Yoon1 , H.-S. Lee1 , H.-C. Kim2 , N.-J. Yi3 , K.-W. Lee3 , K.-S. Suh3 , J.W. Chung2 , Y.J. Kim1 . 1 Department of Internal Medicine and Liver Research Institute, 2 Department of Radiology, 3 Department of Surgery, Seoul National University College of Medicine, Seoul, Korea, Republic of E-mail: [email protected] Background and Aims: The optimal treatment strategy for resectable large (≥5 cm) solitary hepatocellular carcinoma (HCC) is still controversial. This study aimed to compare the long-term outcomes of hepatic resection and transarterial chemoembolization (TACE) as the initial treatment for resectable large solitary HCC. Methods: A total of 91 and 68 consecutive patients with resectable large solitary HCCs who underwent hepatic resection and TACE, respectively, were analyzed. Matched groups of patients were selected, 56 patients per group, using a propensity score model. Overall survival and time to progression (TTP) were analyzed. Independent predictors of overall survival were identified using the Cox proportional hazards model. Results: The hepatic resection group and the TACE group had similar overall survival rates (P = 0.110). The overall survival of the two matched groups by propensity score model remained comparable (P = 0.543). The 1-, 3-, and 5-year overall survival rates of the matched hepatic resection and TACE groups were 87.5%, 76.8%, 64.3% and 92.9%, 76.8%, 53.6%, respectively. In contrast, TTP was significantly longer in the hepatic resection group than in the TACE group (P = 0.004). Patients who underwent subsequent hepatic resection after initial TACE had longer overall survival than patients who underwent hepatic resection initially, though the difference was not statistically significant (P = 0.317). The presence of portal hypertension was determined to be an independent predictor for shorter overall survival (P = 0.017). Conclusions: Hepatic resection and TACE lead to comparable longterm survival for resectable large solitary HCC. Further studies are warranted to compare the long-term outcomes of hepatic resection and TACE. P969 ARTERIAL BLOOD SUPPLY OF HEPATOCELLULAR CARCINOMA IS ASSOCIATED WITH EFFICACY OF SORAFENIB THERAPY Y. Yan, J. Li, L. Huang, J. Yan, F. Xu. Department of Hepatic Surgery I, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China E-mail: [email protected] Background and Aims: The relationship between prognosis of patients treated with sorafenib and parameters of computed tomography (CT) and magnetic resonance imaging (MRI) has been reported. This study aimed to identify predictive factors for survival placing emphasis on the correlation of imaging findings and survival in patients with hepatocellular carcinoma (HCC). Methods: From April 2009 to December 2010, 38 consecutive HCC patients treated with sorafenib were included in this study. HCCs were classified as good arterial supply and poor arterial supply according to the enhancement intensity on CT scan or MRI. Clinical data were collected and analyzed. Results: Among these 38 patients, the median survival time (MST) was 10.7 months (95% CI, 8.7–12.7) and the 1-year overall survival (OS) was 41.0%. On univariate analysis, patients who had tumors with good arterial supply had longer survival time compared with those patients who had tumors with poor arterial supply (P = 0.002), and only arterial supply of the tumors remained statistically predictive for overall survival on multivariate analysis (HR 0.22, 95% CI, 0.07–0.67, P = 0.008). S398

Conclusions: Arterial blood supply is an independent predictor for survival in HCC patients treated with sorafenib, and patients who had tumors with good arterial supply can benefit more from sorafenib therapy. P970 IS IT NECESSARY TO DO A TRANSARTERIAL CHEMOEMBOLIZATION BEFORE HEPATECTOMY FOR RESECTABLE MULTINODULAR HEPATOCELLULAR CARCINOMA? A PROSPECTIVE CONTROLLED STUDY Y. Yan, L. Huang, J. Li, J. Yan, F. Xu, J. Cao. Department of Hepatic Surgery I, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China E-mail: [email protected] Background and Aims: Previous studies have declared good results of hepatectomy for resectable multinodular hepatocellular carcinoma (HCC), but not for 3 more HCCs. This study aimed to investigate that whether patients with resectable multinodular HCCs (2 to 3 nodules) can benefit from transarterial chemoembolization (TACE) before hepatectomy in nodule number comfirmation and clinical outcomes. Methods: From October 2009 to September 2012, 66 consecutive patients with resectable multinodular HCCs (2 to 3 nodules) were prospectively enrolled in the study. Among these, 50 patients were divided in group A (patients received hepatectomy and digital substraction angiography (DSA) 2–4 weeks afterward) and 16 patients in group B (patients received TACE and computed tomography scan 4 weeks afterward before surgery) according to the patients’ own choice. Results: In group A, 13 (26.0%) patients had remnant tumor nodules comfired by DSA after hepatectomy. In group B, 4 (25.0%) patients had tumor numbers different from that of pre-TACE examination. Only 5 (31.2%) patients in group B received hepatectomy, while 11 (68.8%) patients received local ablation treatments duo to good results of TACE or more than 3 HCCs. The mean survival time was 29.7±12.4 months in group A, compared with 31±14.4 months in group B (P = 0.726). The 1-, 2- and 3-year survival rates were 94.0%, 62.0% and 38.0% in group A, compared with 93.8%, 62.5% and 37.5% in group B (P = 0.477). Conclusions: TACE seems necessary for patients with resectable multinodular HCCs (2 to 3 nodules) before surgery. Once TACE has good results or finds more than 3 HCCs, surgery can be avoided. P971 VITAMIN K DOSING AND BRANCHED CHAIN AMINO ACIDS SUPPLEMENTATION COULD IMPROVE THE PROGNOSIS OF SORAFENIB-TREATED PATIENTS WITH HEPATOCELLULAR CARCINOMA Y. Haruna, A. Inoue. Department of Gastroenterology and Hepatology, Osaka General Medical Center, Osaka, Japan E-mail: [email protected] Background and Aims: The anticancer outcome of sorafenib, the only oral anticancer agent for hepatocellular carcinoma (HCC), is not necessarily satisfying. While vitamin K was often given for precaution against osteoporosis, it was reported that combination of vitamin K and sorafenib had a synergistic inhibitory effect on Raf kinase. The branched chain amino acids (BCAA) supplementation was done to preserve liver function for patients with HCC. In this study, we examined retrospectively the influence of the vitamin K and BCAA in sorafenib treatment. Methods: Twenty-three sorafenib-treated patients with the Barcelona Clinic Liver Cancer (BCLC) stage B (intermediate) were studied. Ten patients were orally given vitamin K2 (45 mg daily), and 10 had BCAA supplementation (9.0g daily). Five patients had both vitamin K and BCAA dosing. We compared progression free survival (PFS) and overall survival (OS) in the dosing and sorafenib

Journal of Hepatology 2014 vol. 60 | S361–S522