Page 245 - ebook HCC

PROGRAMME AND ABSTRACTSAND ABSTRACTS
GENEV
EASL HCC SUMMITHCC SUMMIT
243
242
242 PROGRAMME GENEVA, SWITZERLANDA, SWITZERLAND EASL 243
FEBRUAR
FEBRUARY 13 - 16, 2014Y 13 - 16, 2014
Poster Board Number C30
ACOUSTIC RADIATION FORCE IMPULSE
(ARFI) AS PREDICTOR OF ASCITES IN
CIRRHOTICS UNDERGOING RESECTION FOR
HEPATOCELLULAR CARCINOMA (HCC): A NEW
FRIEND FOR THE PHYSICIAN?

Adriano De Santis , Gianluca Grazi , Massimo Rossi , Claudia Iegri , Conclusions: Our study shows that LS evaluated with ARFI could be useful for a better
1
2
3
1
Marinella Lupo , Chiara Bassanelli , Giulia Gallusi , Mariana Forlino , selection of patients candidate to resection allowing to individuate patients with higher risk
1
1
1
1
Carmen Di Ciesco , Andrea Scarinci , Adolfo F. Attili 1 of post-surgery decompensation.
1
2
1 Clinical Medicine Department, La Sapienza University, Gastroenterology Division,
2 Department of Hepato-biliary-pancreatic Surgery, Cancer National Institute Regina
3
Elena, Department of Trasplant Surgery, La Sapienza University, Rome, Italy
Clinical characteristics of enrolled population
Corresponding author’s e-mail: giulia.gallusi@gmail.com at baseline (n=27)
Introduction: ARFI has been used to predict hepatic decompensation after resection Age (years, mean + ds) 68.5 ± 8.7
in patients with liver stiffness values compatible with mild-moderate fibrosis. Data about
ARFI as predictor of post-surgical ascites in cirrhotics lack. Sex:
• M (n- %) 17 (63%)
Aims: To assess the role of liver stiffness (LS) evaluated with ARFI in predicting the • F (n- %) 10 (37%)
occurrence of ascites after liver resection for HCC in cirrhotics.
Methodology: Between December 2010 and September 2013, 28 patients underwent BCLC
surgical resection for HCC. For each patient, LS was performed about 89 days before • A (n- %) 21 (78%)
6 (22%)
• B (n- %)
surgery (median value; 95 %CI: 62-128 d). One patient without cirrhosis was excluded
from the analysis. Child-Pugh score (mean ± ds) 5.2 ± 0.45
CLINICAL POSTER ABSTRACTS died two days after surgical resection for perioperatory massive bleeding. In this patient Meld score (mean + ds) 7.2 ± 1.2 CLINICAL POSTER ABSTRACTS
Results: Clinical characteristics of the population are represented in Tab.1. One patients
Prior procedures
basal LS was 31.2 kPa. During follow-up the only complication observed was the
3 (11%)
• TACE (n- %)
occurrence of ascites. Median value of LS was 14.5 kPa (95%CI: 6.9-18.3); the population
• Radio frequency (n- %)
1 (4%)
was stratified according to stiffness median value in group A (≥14.5 kPa;14 pts) and
• Resection (n- %)
1 (4%)
group B (<14.5 kPa;13 pts). These two groups did not differ according to Child-Pugh,
MELD, BCLC and age. In group A, 7 patients out of 14 developed ascites with a mean
time of 21.7 days (range: 4-67), while in group B no complication occurred (p=0.02). At • Sorafenib (n- %) 1 (4%)
multiple regression including age, CP score,MELD score and BCLC,LS resulted to be the
only independent predictor of ascites (p=0.0018; 95%C.I: 0.01-0.04). At ROC curve for
ascites and LS, the value of 14.5 kPa resulted as the best cut-off in identifying patients
that develop post-surgical ascites (sensitivity: 84%; specificity:67%) with an AUC of 0.86
(95%CI: 0.54-0.96).