If biliary complications develop at a younger age, they are less likely to be successfully treated by non-surgical approaches. Disclosures: The following people have nothing to
disclose: Nicholas Fidelman, Andrew Lee, Robert Kerlan, John P. Roberts Purpose: Although the Milan criteria have been accepted as standard selection criteria for liver PD0325901 transplantation (LT) candidates with hepatocellular carcinoma (HCC), many transplant centers have accepted some extended criteria and focus on the patient selection. The purpose of this study is to evaluate whether neurtophil-lymhocyte ratio (NLR) and C-reactive protein (CRP) predict survival of patients with HCC who undergo LT. Methods: From October 2000 to November 2011, 224 patients underwent living donor liver transplantation (LDLT) for HCC at our institution. Results: Akt inhibitor 37 patients (16.5%) experienced HCC recurrence during the study period. The 5 yrs disease free survival (DFS) and overall survival (OS) were 81.6% and 76.6% respectively. In multivariate analysis, DFS and OS were significantly related to AFP > 100 (P=0.017, P=0.048), maximal tumor size > 5cm (P<0.001, P=0.001), NLR >6 (P=0.049, P=0.003),
CRP >1.0 (P=0.010, P<0.001). The patients with NLR <6 or CRP <1.0 were significantly better DFS and OS than the patients with NLR >6 or CRP >1.0, especially in beyond Milan criteria group. The scoring system with NRL and CRP were correlated with prediction of DFS and OS. Conclusion: Preoperative NLR and CRP are useful biomarkers for predicting DFS and OS, especially in beyond Milan criteria. Combined with the Milan criteria, NLR and CRP may be new selection criteria for LDLT candidates with HCC. Disclosures: The following people have nothing to disclose: Dong Goo Kim Background. There are no studies measuring the impact of tumor morphological staging, microvascular
invasion (mVI), and model-for-end-stage-liver-disease (MELD) score on the benefit of liver transplantation (LT) over hepatic resection (HR) for hepatocellular carcinoma (HCC). Methods. Exclusion criteria: very large (>10 cm) tumours, macrovascular invasion and extra-hepatic metastases. Study population: 1106 HCC cir-rhotic ALOX15 patients undergoing HR from one Eastern (n=424) and two Western (n=682) surgical units. We identified 3 tumor stages: I (within Milan, n=806), II (beyond Milan within Up-to-7, n=123), III (beyond Milan and Up-to-7, n=177). Patient survival observed after HR by proportional hazard regression model was compared to that predicted after LT by the Metroticket calculator. The benefit obtainable from LT compared to resection was analyzed in relationship with staging, mVI, and MELD using Monte Carlo simulation. Results. MELD score had the most important effect on transplant benefit independently form tumor characteristics: mean 5-year LT benefit was −2.22 months (95% CI, −2.45 – −1.98) for patients with MELD score < 10, and 6.32 months (95% CI, 6.08–6.