P-118 HEPATOCELLULAR CARCINOMA. AN EXPERIENCE IN A TRANSPLANT CENTER IN COLOMBIA

Introduction and Objectives

Hepatocellular carcinoma (HCC) is the sixth most frequent type of cancer and the fourth cause of death related to cancer worldwide. Remarkably, HCC is the most common type of liver cancer. According to the International Agency for Research on Cancer (IARC), the incidence of liver cancer in Colombia was 2%, with a 4% mortality in 2020. This study aimed to describe the clinical characteristics of patients with HCC at a liver transplant center in Colombia in the period 2015 to 2020.

Materials and Methods

Descriptive study of consecutive patients with HCC. We developed an HCC registry from our outpatient Clinic in which we reported clinical status, imaging, and therapeutic management. The continuous variables were described as the mean and standard deviation, and nominal variables were evaluated based on frequencies and percentages. All analyses were done in Statistical Package for the Social Sciences (SPPS) v. 21.0.

Results

In total, 131 HCC patients were included, 76 men and 37 women, with an average age of 65 years. Of these patients, 40% were classified as CHILD PUGH (CP) - A, 42% were CP-B and in less proportion, 16.7% were CP-C. The etiology of the cirrhosis was diverse; most cases had a history of alcoholism (34%) and a past medical history of B and C viral infection (23.6%). The radiological characteristics of patients with HCC are shown in table 1. Therapeutic interventions assessed were radiofrequency ablation (ARF 61.6%), microwave ablation (AMO, 7.53%), transarterial chemoembolization (TACE, 30.8%) and liver transplant after ablative treatment (20.5%). Different outcomes analyzed were complete responses for ARF (52.2%), AMO (72.7%) and TACE (4.4%).

Conclusions

In our historical cohort, liver function allowed the achievement of curative therapeutic interventions (ARF/AMO) with a complete response in more than 50% of patients intervened and 20% of patients taken for a liver transplant. Our results highlight the importance of premature detection of high-risk patients and early therapeutic interventions in this population of patients.

Table. Radiological characteristics of patients with HCC

Liver lesions (HCC)		location of liver lesions
Number of lesions	n (%)	Hepatic segment	n (%)
1 lesion	63 (70)	Segment II	4 (6,2)
2 lesions	12 (13,3)	Segment III	2 (3,0)
3 lesions	10 (11,1)	Segment IV	15 (22,7)
4 lesions	2 (2,2)	Segment V	6 (9,1)
5 lesions	2 (2,2)	Segment VI	10 (15,2)
6 lesions	1 (1,1)	Segment VII	16 (24,2)
		Segment VIII	13 (19,7)
LIRADS		Radiological performance
LIRADS 4*	17 (19,3)	Arterial enhancement	65 (72,2)
LIRADS 5	71 (80,7)	Contrast wash	62 (68,9)
		Pseudocapsule formation	40 (44,4)
		Restriction	13 (14,4)

* confirmed with histopathology