3:09 PM Abstract No. 132 Complete stasis embolization may convey survival benefit in hepatocellular carcinoma patients treated with doxorubicin eluting bead transcatheter arterial chemoembolization

Purpose: Recently Brown et al suggested complete stasis transcatheter arterial embolization (TAE) and complete stasis transcatheter arterial chemoembolization (TACE) have similar outcomes in patients with hepatocellular carcinoma (HCC). In 2011, Jin et al demonstrated higher survival rate with substasis endpoints compared to higher stasis endpoints using conventional TACE (cTACE). The purpose of our study is to investigate whether substasis endpoints in the relatively new doxorubicin eluting bead (DEB) TACE has better survival when compared with complete stasis endpoints in HCC patients. Materials: Retrospective cohort study was performed in HCC patients who underwent DEB TACE as their first line therapy from 2008‐2016. Exclusion criteria included lack of postembolization angiogram. The patients were classified based on the subjective angiographic chemoembolization endpoints (SACE) levels on the postembolization angiogram. The median survival rate was the primary outcome. Mean age of SACE groups 2, 3, and 4 were 62.7, 62.6, and 62.2 respectively. The M:F gender ratio for SACE groups 2, 3, and 4 were 2.1:1, 1:2, and 1.2:1 respectively. Kaplan‐Meier curves were calculated to compare the survival rate between the different SACE levels, using significance level of 0.05. Results: 155 patients were included in our study: 98 classified as SACE level 2, 30 as SACE 3, and 27 as SACE 4. Results show SACE 4 (median: 14.7 months) has better survival in patients who survived 25 months with SACE 2 (median: 31.2 mo. [IQR 10.9]) when compared with SACE 3 and 4 (median: 30.1 mo, [IQR 2.7] and 29.9 mo, [IQR 14.1] respectively), p = 0.65. Stratified analysis among these patients shows that the survival rate of SACE 2 and 3 (median: 30.2 mo, [IQR 10.2]) is similar to SACE 4 (median:29.9 mo. [IQR 14.1]), p = 0.46. Conclusions: DEB TACE with SACE level 4 has better survival rate compared to SACE 2 or 3 by over 5 months, in HCC patients who survived less than 25 months. After 25 months, survival rates were similar. Complete stasis embolization may convey short‐Term survival benefit.