P0996 - Fibrolamellar Hepatocellular Carcinoma: An Epidemiologic and 5-Year Cancer Survival Assessment Based Off SEER Data

Mark Aloysius, MD, PhD¹, Peter Iskander, MD², Khalid Ahmed, MD³, Udit Asija, MD³, Elmkdad Mohammed, MD³, Anthony Iskander, ⁴, Niraj Shah, MD⁵, Simin Nasr, MD³, Hemant Goyal, MD⁶, Vikas Khurana, MD³, Ganesh Aswath, MD⁷, Savio John, MD^1
1SUNY Upstate Medical University, Syracuse, NY; ²The Wright Center for GME, Dunmore, PA; ³The Wright Center for GME, Scranton, PA; ⁴Xavier University School of Medicine, Oranjestad, Aruba; ⁵University of Mississippi Medical Center, Jackson, MS; ⁶Borland Groover, Jacksonville, FL; ⁷Upstate University Hospital, Syracuse, NY

Introduction: Fibrolamellar hepatocellular carcinomas (FL-HCC) are a subset of malignancies that only make up roughly 1% of liver cancers in the US. We utilized the Surveillance, Epidemiology, and End Results (SEER) database to examine the epidemiological association and 5-year cancer survival rates of this malignancy in the US.

Methods: We searched the SEER database to include patients diagnosed with FL-HCC from 1998 to 2016. Epidemiologic variables included age, sex, and race. 5-year survival analysis was performed using the Kaplan-Meier graphs. These variables included: combined chemotherapy with surgery, chemotherapy alone, the extent of lymph node (LN) resection, stage of disease, and finally, the extent of surgical intervention.

Results: The average age was 30.2 years. Incidence rates were lowest in Asians, followed by the black population. Disease staging showed that 33.6% had localized disease, 29.8% had regional spread, and 27.7% had distant metastasis. Surgery was performed in nearly half of the patients, while 37.3% underwent chemotherapy alongside surgery. Patients who received chemotherapy without surgery had a mean survival time of 32.2 months, while those who had chemotherapy with surgery had a mean survival time of 83 months. Lymph node (LN) resection was performed in 27.66% of patients and was associated with a mean survival time of 95.7 months, while patients who did not undergo LN resection had a mean survival time of 66.2 months. Different surgical approaches had varying mean survival times, with wedge resection having the highest (137 months) and local tumor destruction having the lowest (26 months) mean survival time. Chemotherapy was associated with lower mean and median survival times compared to patients who did not receive chemotherapy. (Table 1)(Figure 1-6).

Discussion: In conclusion, fibrolamellar hepatocellular carcinoma (FL-HCC) predominantly affects younger white males. Liver biopsies and fine needle aspirates aid in distinguishing FL-HCC from the classic version. Surgery is the preferred treatment, offering a favorable survival outcome, while chemotherapy alone leads to worse outcomes. In terms of survival advantage for surgery, best outcomes were with wedge resection and worst with local tumor destruction. LN resection yielded a 29.4-month increase in their 5-year survival with the extent of spread being inversely proportional to survival time.




Disclosures:


Mark Aloysius, MD, PhD¹, Peter Iskander, MD², Khalid Ahmed, MD³, Udit Asija, MD³, Elmkdad Mohammed, MD³, Anthony Iskander, ⁴, Niraj Shah, MD⁵, Simin Nasr, MD³, Hemant Goyal, MD⁶, Vikas Khurana, MD³, Ganesh Aswath, MD⁷, Savio John, MD¹. P0996 - Fibrolamellar Hepatocellular Carcinoma: An Epidemiologic and 5-Year Cancer Survival Assessment Based Off SEER Data, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.