Abstracts
2000 Digestive Disease Week

# 2271 Hepatitis Serology as a Prognostic Factor in Patients with Hepatocellular Carcinoma.
Syed A. Ahmad, Malcolm M Bilimoria, F Izzo, P. Delrio, P. Marra, Trent P. Baker, Geoff A. Porter, Lee M. Ellis, Jean N. Vauthey, S. Dhamotharan, Steven A. Curley, Houston, TX, Naples, Italy

Introduction: Although viral hepatitis is associated with hepatocellular carcinoma (HCC), positive serology has not been clearly implicated as a prognostic factor for this disease. The goals of this study were to compare, in patients undergoing resection for HCC, 1) the prognostic factors for patients with hepatitis B or C virus infection and 2) the survival of hepatitis positive HCC patients with hepatitis negative HCC patients. Methods: A retrospective review of cirrhotic patients who underwent liver resection for HCC between January 1990 and December 1998 was performed. Tumor stage, hepatitis serology, vascular invasion, presence of satellitosis, surgical procedure, local-disease free survival (LDFS), distant-disease free survival (DDFS) ,overall survival (OS), and standard demographic data were obtained. Results: There were 77 cirrhotic patients who underwent resection of HCC. Forty-four patients (57%) had positive serology for hepatitis C, 18 patients (23%) for hepatitis B, and 15 patients (20%) had negative serologies. There were no differences in age, gender, or tumor size, and all patients had margin- negative resection. There was a significantly higher incidence of satellitosis and vascular invasion in patients with hepatitis C (32% and 41% respectively) when compared to the other cohort of patients (8% and 26% respectively; p<0.05). With a median follow-up of 30 months, a significantly decreased LDFS was seen in patients with either hepatitis B (5-yr LDFS 26%; p<0.05) or hepatitis C (5-yr LDFS 38%; p<0.05) compared to patients with negative serology ( 5-yr LDFS 79%). There was a trend towards a decreased OS in patients with positive hepatitis serologies compared to patients with negative serology (37% vs 79%; p=0.1), but since median survival has not yet been reached, this did not attain significance. There was no difference in DDFS amongst the three groups. Conclusion: Patients with positive serology for hepatitis B or C undergoing hepatic resection for HCC have 1) a trend toward worse overall prognosis and 2) significantly decreased local DFS when compared to patients with negative serologies. Effective adjuvant therapy is needed for hepatitis positive patients with HCC in order to improve outcome.