973P Clinicopathologic and treatment outcome data in 165 fibrolamellar carcinoma patients

Fibrolamellar carcinoma (FLC) is a rare subtype of liver cancer that primarily affects young adults and adolescents. The main objective of this study is to evaluate the association between survival outcomes and clinical factors of patients with FLC. We retrospectively collected clinicopathologic and treatment outcome data from 88 male and 77 female patients with a pathologic diagnosis of FLC. Median overall survival (OS) was calculated using Kaplan-Meier curves. Log rank test, univariable and multivariable Cox models were applied to evaluate the association between clinical outcomes and patients’ characteristics. Mean age at diagnosis was 27.4 years (age range: 9, 76), median OS was 42.6 months (95% CI: 36.5, 59.2). 50.3% of patients in our study were AJCC Stage IV at the time of presentation, with 67.5% having vascular invasion at diagnosis. 5% of patients had liver cirrhosis. 68.5% of patients received surgery, including metastasectomy. 30.9% received radiation therapy, and 77.5% received systemic therapy. Combination of 5-fluorouracil and interferon-alpha2 was the most frequently used systemic therapy (83 patients), with 45 patients receiving other forms of chemotherapy. The median OS of patients who underwent surgery was 59.2 months (95% CI [49.51, 89.68]) versus 20.34 months (95% CI [15.37, 26.02] in patients who did not. Of those who did not have surgery, 94.2% (49 patients) had AJCC stage >II. Higher tumor stage(>II) (HR=2.841; 95% CI [1.309, 6.165]), lack of surgery (HR=3.47; 95% CI [2.193, 5.488]) and lack of receipt of radiation therapy (HR=1.685; 95% CI [1.059, 2.68]) were positively associated with worse OS. We identified prognostic factors in FLC. The associations of receipt of surgery and radiation with prolonged OS suggest that local control and cancer debulking in this disease is paramount.