Page 200 - ebook HCC

PROGRAMME AND ABSTRACTSAND ABSTRACTS
EASL
GENEV
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198 PROGRAMME GENEVA, SWITZERLANDA, SWITZERLAND EASL HCC SUMMITHCC SUMMIT 199
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FEBRUARY 13 - 16, 2014Y 13 - 16, 2014
FEBRUAR
Poster Board Number C2 Poster Board Number C3
STUDY OF FACTORS ASSOCIATED WITH POOR ROLE OF DIETARY SUPPLEMENT AND
SURVIVAL IN PATIENTS WITH NONRESECTABLE SORAFINEB IN THE MANAGEMENT OF END-
HEPATOCELLULAR CARCINOMA STAGE HCC PATIENTS

Alaa A. Taha , Abdel-Aziz Saleem , Mohammad Al-Talkawy , Nevin Yilmaz 2 Mamun A. Mahtab , Sheikh F. Akbar , Salimur Rahman 1
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1 Hepatogastroenterology, Theodor Bilharz Research Institute, Cairo, Egypt, 1 Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka-1213, Bangladesh,
2 Hepatogastroenterology, Mugla University, Mugla, Turkey 2 Medical Sciences, Toshiba General Hospital, Tokyo, Japan
Corresponding author’s e-mail: alaataha_eg@hotmail.com Corresponding author’s e-mail: shwapnil@agni.com
Introduction: Hepatocelluar carcinoma (HCC) ia a major malignancy in Egypt with a Introduction: A total of 96 patients with end stage HCC were enrolled in this study. Thirty-
rising incidence over the last two decades and it is one of the leading causes of malignant eight patients with end-stage HCC (Barcelona Clinic Liver Cancer [BCLC] staging C and
mortalities in male patients. Majority of patients present at late nonresectable stages of D) were enrolled in the study as control and did not receive any specific medication as per
the disease and this may be attributed to lack of effective surveillance program for patients their desire. Thirty-four patients with end-stage HCC (BCLC staging C and D) received only
with chronic hepatitis and hepatic cirrhosis. oncoxin, a dietary supplement containing high concentrations of vitamins, amino acids,
and herbal extracts. Twenty-four patients with end-stage HCC received both oncoxin and
Aims: The aim of this work is to study the factors associated with poor survival in patients sorafenib.
with nonresectable HCC.
Aims: To evaluate the role of only dietary supplement or a combination of dietary
Results: The study included 889 patients (744 males and 145 females) who presented supplement and sorafenib for management of patients with end-stage hepatocellular
with nonresectable HCC. Patients were fully evaluated and closely followed up for disease carcinoma (HCC).
progression and complications. Their demographic, clinical, laboratory and radiological
data were analyzed for detection of risk factors associated with poor survival. Results: Only 4 of 38 patients (11%) of control group survived for more than 2 months
Median survival in our patients was 23 months. Two independent factors were recognized and all of them died within 3 months of enrollment. In contrast 16 of 34 patients (47%)
to be associated with poor survival when detected at first presentation of patients; ascites receiving only oncoxin survived for more than 2 months. Four patients receiving only
(median survival 11 months, p=0.019) and portal vein tumor thrombosis (median survival oncoxin survived for more than 6 months. Although there were no notable adverse effects
CLINICAL POSTER ABSTRACTS hyperbilirubinemia (p=0.027), elevated serum gamma glutamyl transpeptidase (GGT) continued both oncoxin and sorafenib survived for more than 6 months. Regarding QOL CLINICAL POSTER ABSTRACTS
9 months, p=0.012). Other factors associated with adverse prognosis and poor survival
of patients receiving only oncoxin, 8 patients receiving both oncoxin and sorafenib showed
included markedly elevated serum alpha feto protein (AFP) levels > 1000 ng/ml (p=0.023),
adverse effects for which sorafenib were discontinued. Ten of 16 patients (62%) that
levels (p=0.029), elevated serum alkaline phosphatase levels (p=0.34) and elevated
on the basis of Karnofsky Performance Scale Index decreased in all patients of control
serum aspartate aminotransferase (AST) levels (p=0.046). Survival was not influenced by
group (decreased to 50%; at one month after study commencement compared to their
levels of 100% at enrollment). However, the levels of QOL mostly increased in majority of
age, gender nor the etiologic hepatitis virus.
Main causes of death in our series included advanced hepatic encephalopathy (32%),
severe sepsis including spontaneous bacterial peritonitis (27.7%), hepatorenal syndrome
(21.3%) and osophagogastric variceal bleeding (19%). patients receiving oncoxin and oncoxin plus sorafenib.
Conclusions: This study indicates that different regimen of dietary supplement alone or
with sorafenib may be used for management of end-stage HCC.
Conclusions: In conclusion, the presence of ascites and/or portal vein tumor thrombosis
at first presentation of the disease is independentally associated with poor survival in
patients with nonresectable HCC. Other factors associated with poor survival include
elevated serum AFP, bilirubin, GGT, alkaline phosphatase and AST levels.