Abstract No. 563 TP53 Mutation Predicts Worse Survival and Earlier Local Recurrence In Hepatocellular Carcinoma Treated with Transarterial Embolization

To evaluate the association of TP53 mutation with outcomes after transarterial embolization (TAE) of hepatocellular carcinoma (HCC). Single-institution study that included prospectively accrued patients from 1/2014 to 6/2022 and retrospectively identified patients from 1/2011 to 6/2022 who underwent standard-of-care TAE for treatment of HCC and genetic analysis of tumoral tissue. The primary outcome was overall survival (OS) with relation to TP53 status. The secondary outcome was time to progression with relation to TP53 status. Survival analysis was performed using the Kaplan-Meier method and univariate Cox regression. Time to progression with death or last patient contact without progression as competing risks was used to obtain a cumulative incidence function, and the association with TP53 status was evaluated using the Gray test. A total of 75 patients (63 men) with median age 70.0 (IQR 62.0-76.3) years were included, and TP53 mutation was present in 26/75 (34.7%). TP53 mutation was associated with significantly worse median OS of 15.2 (95% CI, 9.5-29.3) months versus 31.2 (95% CI, 21.2-52.4) months median OS (p=0.023) for TP53 wild-type. On univariate analysis, TP53 mutation (p=0.025), AFP >200 ng/mL (p< 0.001), ECOG performance status of 1 or 2 (not 0) (p=0.008), BCLC Stage B or C (not A) (p=0.001), and >1 tumor (p=0.013) were significantly associated with worse OS. Competing risk analysis showed shorter time to local hepatic progression (at site of previously treated tumor) after TAE in TP53 mutants. Cumulative incidences of local progression were 65.4% (95% CI, 46.0%-84.8%) at 6 months and 84.6% (95% CI, 69.4%-99.8%) at 12 months for TP53 mutants, versus 40.8% (95% CI, 26.6%-55.1%) at 6 months and 55.1% (95% CI, 40.6%-69.6%) at 12 months for TP53 wild-types (p=0.0072) (Table 563.1). TP53 mutation may predict worse overall survival and shorter time to local recurrence in HCC patients treated with TAE.