Page 208 - ebook HCC

GENEV
PROGRAMME AND ABSTRACTSAND ABSTRACTS
EASL
206 PROGRAMME GENEVA, SWITZERLANDA, SWITZERLAND EASL HCC SUMMITHCC SUMMIT 207
207
206
FEBRUAR
FEBRUARY 13 - 16, 2014Y 13 - 16, 2014
Poster Board Number C8
SEVERE 25-HYDROXYVITAMIN D DEFICIENCY
IDENTIFIES HEPATOCELLULAR CARCINOMA
PATIENTS WITH A POOR PROGNOSIS

Fabian Finkelmeier , Bernd Kronenberger , Verena Köberle , Table: Univariate and multivariate analyses of parameters associated with overall survival.
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Stefan Zeuzem , Albrecht Piiper , Oliver Waidmann 1
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1 Medizinische Klinik 1, Klinikum der Goethe-Universität, Frankfurt, Germany Univariate analysis Multivariate analysis
Corresponding author’s e-mail: waidmann@biochem2.uni-frankfurt.de
Parameter HR 95% CI 1 P value HR 2 95 % CI P value
Introduction: Vitamin D is involved in many biological functions. It is has been identified Age ≤ 65 years 0.954 0.573-1.589 0.856
as prognostic factor in several diseases and even as potential treatment option in multiple 3
cancers. The role of vitamin D in patients with Hepatocellular carcinoma (HCC) remains BCLC stage AB 0.439 0.259-0.744 0.002
inconclusive although there is evolving evidence that vitamin D may modulate cancer 25(OH)D ≤ 10 ng/ml 2.225 1.331-3.719 0.002 1.755 1.040-2.962 0.035
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development and progression.
CLIP 0-2 0.331 0.194-0.565 < 0.001 0.488 0.282-0.845 0.010
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Aims: To evaluate vitamin D as prognostic parameter, HCC patients were prospectively CRP ≤ 0.5 mg/dl 0.222 0.119-0.414 < 0.001 0.273 0.145-0.513 < 0.001
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recruited and 25-hydroxyvitamin D3 (25(OH)D ) levels were determined. Vitamin D levels
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were compared to stages of liver cirrhosis and HCC stages with non-parametric Kruskal- Abbreviations: CI, confidence interval; HR, hazard ration; BCLC, Barcelona liver clinic;
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Wallis-tests and Spearman correlations. The association of the 25(OH)D levels and 4 CLIP, Cancer of the Liver Italian Program; CRP, C-reactive protein.
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overall survival (OS) was assessed in uni- and multivariate Cox regression models.
Results: 200 HCC patients were included. The mean follow-up time was 322 ± 342 days
with a range of 1-1508 days. 19 patients underwent liver transplantation and 60 patients
died within the observation time. The mean serum 25(OH)D concentration was 17 ± 13
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ng/ml with a range of 1 to 72 ng/ml. 25(OH)D serum levels negatively correlated with
CLINICAL POSTER ABSTRACTS 1.331 - 3.710, P = 0.002). Furthermore, very low 25(OH)D levels were associated with CLINICAL POSTER ABSTRACTS
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the stage of liver cirrhosis as well with stages of HCC. Patients with severe 25(OH)D
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deficiency had the highest mortality risk (hazard ratio 2.225, 95 % confidence interval
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mortality independently from the CLIP score and C-reactive protein levels in a multivariate
Cox regression model (Table).
Conclusions: We conclude, that 25(OH)D deficiency is a prognostic indicator for a poor
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outcome in HCC patients.