Tu1490 STATIN USE IS ASSOCIATED WITH IMPROVED SURVIVAL IN PATIENTS WITH HEPATOCELLULAR CARCINOMA Caitlin C. Citti, Janis Yao, Amandeep K. Sahota, Bechien U. Wu BACKGROUND AND AIMS: Hepatocellular Carcinoma (HCC) is the sixth most common cancer worldwide, and given its relatively poor prognosis, the second most frequent cause of cancer mortality. Based on their pleotropic effects, previous studies have explored the role of statin medications in cancer survivorship. There have been limited studies to address the effect of statins on survival in patients with HCC. We aimed to further characterize the potential benefit of statins in survival of patients with HCC in a large U.S. integrated healthcare system. METHODS: We conducted a retrospective cohort study of patients identified through an internal cancer registry from 2006 - 2013. Patients were included if they were 18 years of age or older at diagnosis, had at least 1 year of continuous membership prior to diagnosis, and at least 28 days of continuous membership following diagnosis. Statin use was captured through electronic pharmacy dispensation records. Statin users at diagnosis were assigned exposure for the entire follow up period, while those starting statins after diagnosis were treated as unexposed until their first prescription. Any use exposures were defined as overall use, versus no statin. Cox regression was used to adjust for the independent effect of statin use as a time-dependent covariate on mortality adjusted by sex, race, age, Charleston comorbidity score, albumin, BMI, MELD-Na at the time of diagnosis, stage at diagnosis, and presence of heart disease or diabetes. RESULTS: There were 1024 patients identified in the internal cancer registry database that met study inclusion criteria (median age of 64 [IQR 58,73], 76% male, 62% stage I/II, median MELD-Na score 10 [IQR 7,14]. Overall, 28% of patients were statin users at baseline. The crude survival time (years) was higher for statin users than for non-statin users (median 1.77 vs 1.45, p=0.046). (Figure 1). In multivariate adjustment, patients who used any statins during the study period had a 23% decrease in the risk for mortality when compared to non-statin users (adjusted HR= 0.77, 95%CI=0.63-0.94, p=0.01) (Table 1). In addition, MELD-Na and tumor stage were associated with increased mortality, whereas albumin was inversely associated with mortality. The presence of heart disease or diabetes was not associated with statistically significant impact on survival. CONCLUSION: In this large regional U.S. cohort, statin use was independently associated with improved survival. Based on their excellent safety profile, further investigation with randomized controlled trial is warranted. Tu1491 EARLY TUMOR DETECTION AND CURATIVE TREATMENT RECEIPT MEDIATE RACIAL AND ETHNIC DISPARITIES IN HEPATOCELLULAR CARCINOMA PROGNOSIS Nicole E. Rich, Caitlin Hester, Mobolaji Odewole, Caitlin C. Murphy, Neehar D. Parikh, Jorge A. Marrero, Adam Yopp, Amit G. Singal Background and Aims: Racial and ethnic minorities have been reported to have higher mortality related to hepatocellular carcinoma (HCC) than non-Hispanic whites. However, prior data lack granularity on tumor characteristics and liver dysfunction, limiting characteri- zation of the cause of this disparity. Our study's aim was to characterize racial/ethnic disparities in HCC presentation, treatment, and survival. Methods: We performed a retro- spective study of patients diagnosed with HCC between January 2008 and July 2017 at two U.S. health systems. We used multivariable logistic regression and Cox proportional hazard S-1237 AASLD Abstracts models to identify predictors of curative therapy receipt (liver transplantation, surgical resection, or local ablation) and overall survival. Results: Among 1117 HCC patients (35.9% White, 34.3% Black, 29.7% Hispanic), 463 (41.5%) were diagnosed at an early stage (Barcelona Clinic Liver Cancer (BCLC) stage 0/A) and 322 (28.8%) underwent curative treatment. In univariate analysis, both Hispanics (OR 0.75, 95%CI 0.55 - 1.00) and Blacks (OR 0.74, 95%CI 0.56 - 0.98) were significantly less likely to found at BCLC stage 0/A than Whites. After adjusting for receipt of HCC surveillance, Hispanics were still less likely than Whites to be detected at BCLC stage 0/A (OR 0.70, 95%CI 0.51 - 0.98); however Black-White differences in early HCC detection were no longer statistically significant (OR 0.76, 95%CI 0.55 - 1.04). In univariate analysis, curative treatment receipt was less likely in Hispanics (OR 0.51, 95%CI 0.37 - 0.70) and Blacks (OR 0.60, 95%CI 0.44 - 0.81) than Whites. Among those with BCLC stage 0/A HCC, Hispanics remained significantly less likely to undergo curative treatment than Whites (OR 0.58, 95%CI 0.36 - 0.91); however, the difference in curative treatment receipt between Blacks and Whites was no longer statistically significant (OR 0.66, 95%CI 0.43 - 1.03). Median overall survival was 8.5 months for all patients. Although Blacks and Hispanics had lower median survival than Whites (7.8 and 8.3 vs. 10.2 months), differences in survival were no longer significant for Hispanics vs. Whites (HR 0.85, 95%CI 0.70-1.03) and Blacks vs. Whites (OR 1.09, 95%CI 0.91-1.30) after adjusting for BCLC stage and receipt of HCC treatment. Disparities in survival between Blacks and Whites were more pronounced in BCLC stage A (16.0 vs 18.7 months) patients compared to those who were BCLC stages B or C (11.8 vs. 9.2 and 4.1 vs 4.2 months, respectively). Conclusion: Racial and ethnic disparities in HCC prognosis are primarily driven by differences in early tumor detection and receipt of curative treatment, highlighting these measures as intervention targets to improve outcomes and reduce disparities. Predictors of Overall Survival BCLC - Barcelona Clinic Liver Cancer; SBRT - stereotactic body radiation therapy; TACE - transarterial chemoembolization; TARE - transarterial radioembolization Tu1492 THE BARRIERS TO IMPLEMENTATION OF MULTIDISCIPLINARY TUMOR BOARD RECOMMENDATIONS AND THEIR IMPACT ON HEPATOCELLULAR CARCINOMA SURVIVAL Carlos R. Diaz, Debra Payne, Beatrice L. Madrazo, Gennaro Selvaggi, Patricia D. Jones, Paul Martin Background: A multidisciplinary approach to managing hepatocellular carcinoma (HCC) is optimal. We identified demographic factors associated with Multidisciplinary Tumor Board (MTB) discussion and barriers to implementing MTB recommendations. Methods: We performed a chart-based retrospective analysis of HCC patients diagnosed at the University of Miami/Jackson Memorial Hospitals between 1/4/2012-12/19/2014 with last follow-up on 4/21/2017. We used univariate, bivariate and Pearson's chi-squared analyses to determine if MTB discussion was associated with survival. Results: We identified 227 HCC patients. By the Barcelona Clinic Liver Cancer (BCLC) Staging System, 7.5% were Stage 0, 43.2% were Stage A, 29.5% were Stage B, 14.1% were Stage C, 4.9% were Stage D, and 0.9% AASLD Abstracts