Sa1875 Therapeutic Inhibition of miRNA-132 Attenuates CCL4-Induced Liver Fibrosis

Abstract

Background: Chronic hepatitis B (CHB) can lead to HCC in either the presence or absence of cirrhosis. In this study, we characterized the baseline characteristics, treatments, and outcomes of HBV-associated HCC patients by cirrhosis status.Methods: This was a retrospective single-center cohort study of 493 consecutive patients diagnosed with HBV-related HCC at a U.S. university medical center between 2005 and 2014. Patients were identified via ICD-9 diagnosis query for HCC, and were included in the cohort if they had serologic evidence of CHB and HCC diagnosed by pathology or imaging based on AASLD criteria. Patients were designated as having cirrhosis if there was clinical, laboratory, imaging, or biopsy evidence of portal hypertension or fibrosis stage 4. Survival was obtained via chart review and/or National Death Index search. Results: Mean age was 60; 80% were male; 89% were Asian; and 62% had cirrhosis. Compared to patients without cirrhosis, those with cirrhosis were older (mean age 61.2 vs. 57.5 years, p = 0.002) and more likely to have hypertension (46.4% vs. 35.4%, p = 0.02) and diabetes (29.2% vs. 13.6%, p < 0.001). Patients with and without cirrhosis had similar baseline BCLC stage (70.7% vs. 77.0% stage A or B, p = 0.14) and proportion of patients within UCSF(57.4% vs. 52.8%, p = 0.36) or Milan (37.1% vs. 40.8%, p = 0.45) criteria for liver transplantation (LT). Patients with cirrhosis were much less likely than those without cirrhosis to undergo partial hepatic resection (19.6% vs. 34.6%, p < 0.001), more likely to undergo LT (9.1% vs. 1.4%, p < 0.001), and equally likely to undergo any surgical treatment (28.7% vs. 35.9%, p = 0.10). Interestingly, survival did not depend on cirrhosis status for the first two years after diagnosis, but diverged significantly thereafter (Fig. 1A). Surgical treatment was associated with improved survival relative to nonsurgical treatment, particularly among patients without cirrhosis, who had 5-year survival of 77.1% with surgical treatment vs. 20.5% for nonsurgical treatment, compared to 70.5% and 26.3% for patients with cirrhosis (Fig. 1B). Conclusions: Compared to patients without cirrhosis, patients with cirrhosis and CHB-related HCC presented with similar tumor stage and had similar 2-year survival but markedly decreased 5year survival. Surgical treatments were associated with greater 5-year survival than were nonsurgical options, and the benefit appeared even greater in patients without cirrhosis