P-43 PROGNOSTIC MODELS AFTER TRANSARTERIAL CHEMOEMBOLIZATION IN A LATIN AMERICAN PROSPECTIVE COHORT STUDY

No With the advent of new therapeutic options for patients with hepatocellular carcinoma (HCC) at intermediate stage of the Barcelona Clinic Liver Cancer (BCLC), regional real-world data regarding prognostic survival factors are significant. The aim of this study was to evaluate pre and post-prognostic survival variables after transarterial chemoembolization (TACE). A multicenter prospective cohort study was conducted in Argentina, Chile, Brazil, and Colombia, including HCC patients at BCLC B or C stages who were treated with TACE from 2018 to 2024. The effect on survival since date of first TACE was evaluated through Cox proportional hazard survival analysis. Harrell´s c-statistic index for model discrimination was estimated through somers-d. Overall, 625 patients were included, of which 41.3% (n=258) received TACE (Table 1), and 4.6% (n=29) selective internal radiation therapy (SIRT). The median number of TACEs procedures was 2 (range 1-3); 54.5% conventional TACE, and 44.7% with drug-eluting beads. Median follow-up since first TACE was 17.7 months, with a median overall survival of 27.3 months (range 21.9-35.1). Radiological objective response rates (ORR) after first and last TACEs were 49.2% (95% CI 42.9-55.5%), and 29.0% (95% CI 22.6-36.1%), with significantly better post TACE survival [HR of 0.48 (95% CI 0.29-0.78); P=0.003]. The pre-TACE prognostic model showed liver decompensation was an independent variable associated with increased post TACE mortality was [HR 2.0 (CI 1.28-3.12)], adjusted for performance status, and the HAP score. Pre and post-TACE model showed that the effect of liver decompensation was adjusted [HR 1.7 (CI 0.98-2.8); P=0.06], when ORR after last TACE was achieved and included in this model [HR 0.48 (CI 0.29-0.79); P=0.004], with a c-statistic index of 0.66 (95% CI 0.60-0.72). Radiological response after sequential TACE might reduce the negative effect of liver decompensation on post-TACE survival. However, cautious TACE stopping rules should be considered.