727 HEPATIC ARTERIAL CHEMOEMBOLIZATION FOR THE METASTATIC LIVER CARCINOID

staging systems, and identified discrepancies between treatment options chosen in Korean clinical practice and BCLC guidelines. Methods: Between 2003 and 2008, 1,717 prospectively enrolled patients with treatment-naive HCC were analyzed. Prognostic ability of each staging system was assessed using time-dependent receiver-operating characteristic (ROC) curves. Results: The most common etiology was hepatitis B virus (1,238, 72.1%); 167 (9.8%) patients were classified as BCLC stage 0, 526 (30.6%) as A, 333 (19.4%) as B, 608 (35.4%) as C, and 83 (4.8%) as D. Median overall survival was 22.5 months, and 1-, 2-, 3-, 4-, and 5-year survival rates were 62.6, 48.3, 39.9, 34.7, and 29.3%, respectively. Of 6 staging systems, BCLC had the highest area under ROC (AUROC; 0.821) for overall survival, followed by JIS (0.809), Tokyo score (0.771), CLIP (0.746), CUPI (0.701), and GRETCH (0.685) system. In both subgroups stratified according to treatment strategy (curative vs. palliative), BCLC also showed the best AUROCs (curative, 0.708/palliative, 0.807) for overall survival. Regarding discrepancies between treatment options chosen in our cohort and BCLC guidelines, more than half with very early/earlystage HCC underwent transarterial chemoembolization, rather than resection or local ablative therapy; most of those with advancedstage HCC received intra-arterial chemotherapy-based treatments rather than sorafenib. Conclusion: BCLC was the best long-term prognostic model for treatment-naive HCC in a large-scale Korean cohort. However, treatment modalities did not exactly match BCLC paradigm.