Page 315 - ebook HCC

PROGRAMME
EASL HCC SUMMITHCC SUMMIT
GENEVA, SWITZERLANDA, SWITZERLAND
313
312 PROGRAMME AND ABSTRACTSAND ABSTRACTS GENEV EASL 313
312
FEBRUARY 13 - 16, 2014Y 13 - 16, 2014
FEBRUAR
Poster Board Number C77 Poster Board Number C78
CONTRAST ENHANCED ULTRASOUND (CEUS) PREDICTIVE BIOMARKER FOR SORAFENIB
IN THE DIAGNOSIS AND IN THE FOLLOW UP OF THERAPY IN HEPATOCELLULAR CARCINOMA
HEPATOCELLULAR CARCINOMA (HCC)

Takuya Honda , Tatsuki Ichikawa , Naota Taura , Hisamitsu Miyaaki ,
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Daniela Santovito, Vincenzo O. Palmieri, Lara Ricci, Caterina Capobianco, Alfonso Satoshi Miuma , Hidetaka Shibata , Shinjiro Uchida , Yasuhiro Kamo , Takemasa Seno ,
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Mele, Francesco Minerva, Giuseppe Palasciano Emi Yoshimura , Ikuko Takahara , Kazuto Ashizawa , Kazuhiko Nakao 1
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1 Gastroenterology and Hepatology, Nagasaki University Honpital, Clinical Oncology
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Corresponding author’s e-mail: daniela.santovito83@gmail.com Center, Nagasaki University, Nagasaki, Japan
Corresponding author’s e-mail: takuya-ngsunv@umin.ac.jp
Introduction: The contribution of CEUS in the diagnosis of HCC is controversial with
some guidelines (AASLD, 2011; EASL, 2012) that exclude and other (AISF, 2012) that
state a specific role. Introduction: Sorafenib, the first agent demonstrated to have efficacy to improve the
survival of patients with advanced hepatocellular carcinoma (HCC), is an active multikinase
Aims: To evaluate the accuracy of CEUS in the diagnosis of HCC in cirrhosis and of inhibitor affecting angiogenesis and tumor proliferation.
relapse or residual of HCC after treatment.
Aims: We analyzed cytokines related to angiogenesis or cell proliferation, and tried to
Methodology: Retrospective evaluation of 113 cirrhotic patients with histologically determine their utility as biomarkers of sorafenib treatment effect for HCC.
diagnosis of HCC (median age 71 yrs, 83M/30F, 86 HCV and 15 HBV); 92 subjects
underwent to treatment (6 surgery, 62 TACE; 98 RFA; 25 combination of TACE and RFA, Methodology: A total of 33 patients with HCC diagnosed between 2009 and 2012 in
14 sorafenib); the diagnosis of HCC on CEUS was confirmed on the typical partner: the Department of Gastroenterology and Hepatology, Nagasaki University Hospital, were
sustained hyperenhancement in the arterial, loss of hyperenhancement in portal and recruited for this study. We evaluated the biomarker of all patients in plasma vascular
delayed phases. endothelial growth factor (VEGF), hepatocyte growth factor (HGF), des-gamma-carboxy
prothrombin (DCP) and interleukin-8 (IL-8) levels at the start of sorafenib therapy, and
Results: 72 patients had both CEUS (n=73) and TC (n=71) or MR (n=2) for the initial examined the association between objective tumor response, progression-free survival
diagnosis of HCC, of which 23 with a nodule <20 mm, 50 with a nodule > 20 mm; among and overall survival.
CLINICAL POSTER ABSTRACTS HCC: 66,6vs94, 100vs100, 100vs100, 33vs75; larger HCC: 75vs94, 100vs100, 100vs100, 17out of 33 patients (51%) achieved disease control. The median progression-free survival CLINICAL POSTER ABSTRACTS
treated patients, 28 presented a residual or a relapse of HCC and 34 a complete necrosis.
Sensitivity, specificity, PPV, NPV of CEUS and TC/MR in the initial of HCC were: small
Results: We evaluated patients for Response Evaluation Criteria in Solid Tumors (RECIST),
day of all patients was 120 days. They were categorized into two groups as follows: 1)
28vs60. In the diagnosis of residual or relapse of HCC and in that of complete necrosis,
17 were classified as the responder group: partial response (PR) or stable disease (SD),
the concordance CEUS/TC or MR was 94% and 89%, false negative CEUS were 3% and
and 2)16 were put into the non-responder group: progressive disease (PD). There were
11%, false negative TC/MR were 3% and 0.
was significant lower the responder group than the non-responder group (p = 0.00459).
Conclusion: CEUS may have a role in the initial diagnosis of large HCC and in the follow
The progression-free survival of 17 patients with low IL-8 level (<12.0 pg/ml) group was
up of treated HCC nodules. no significant differences in the VEGF, HGF and DCP levels. However, the plasma IL-8
significantly longer than the high IL-8 (=>12.0 pg/ml) gorup patients (P = 0.00092).
Conclusion: The plasma level of IL-8 can be a predictive marker to assess the tumor
response and progression-free survival to sorafenib therapy.