Multidisciplinary team approach to hepatocellular carcinoma management in a liver transplant center from Romania Cerban R.1, Iacob S.1, Croitoru A.1, Popescu I.3, Dumitru R.2, Grasu M.2, Ester C.1. Pietrareanu C.1, Ghioca M.1, Gheorghe C.1 and Gheorghe L.1 ¹ Center for Digestive Disease and Liver Transplantation, Fundeni Clinical Institute, Bucharest Romania 2 Radiology Department, Fundeni Clinical Institute, Bucharest Romania 3 Dan Setlacec Centre of General Surgery and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania Poster 10 INTRODUCTION / BACKGROUND & AIMS RESULTS Optimal care of the patient with hepatocellular carcinoma (HCC) requires the involvement of multiple specialists. The aim of our study is to evaluate the outcome following the decision taken in a Multidisciplinary Liver Tumor Board for the treatment of HCC. PACIENTS AND METHODS In this prospective study from January 2015 to October 2017 we included 255 treatment naive patients, diagnosed with HCC. All patients were discussed in the Tumor Board by a multidisciplinary team. RESULTS Kaplan-Meier Survival Analysis of 255 patients All patients (M=160, F=95) with an average age of 62 years (±8.1) that were included had cirrhosis (HCV-related in 55.9%). Short-term mortality rate (3 months) was 17.6% (45 patients), 77.8% of those patients being in the BSC group and the rest (10 patients) died on the transplant list due to complications of cirrhosis. Characteristics Values (n=255) Age, median years (range) 62 ± 8,1 Gender, n (male) 160 (62,7%) Etiology   HCV 142 (55,9%) HBV 67 (26,2%) Alcohol 41 (16.1%) Others 5 (1,96%) Child-Pugh class A 128 (50,2,2%) B 75 (29,4%) C 52v(20,4) Platelet, x10³/L 79,6 ± 57,3 Creatinine, mg/dL 1,4 ± 1,1 Albumin, g/L 2,9 ± 0,8 Bilirubin, mg/dL 3,1 ± 1,9 ALT, UI/L 64 ± 59,3 INR 1,7 ± 0,8 MELD score 14,5 (7-28) Characteristics Values (n=255) Tumor number   1 102 (40%) 2 49 (18,4%) 3 37 (14,5%) >3 67 (26,2%) Tumor size, mm 49,6 ± 19,3 Tumor size (>5cm) 74 (29%) Portal vein thrombosis 57 (10,1%) AFP, ng/ml 239,8 (3,2-7280) Liver transplant after TACE procedure 20 (22,2%) Succes rate Resection 9 (81,8%) Ablation 19 (79,3%) TACE 57 (63,9%) Follow up duration, months 18 (3-37) Recurrence 37(58,3%) Short term, mortality (3 months), n Dead 45 (17,6%) Alive 210 (82,5%) Survival outcome end of follow up, n 88 (34,5%) 146 (57,2%) Unknown 21 (8,23%) Thirty four patients had complete tumor response (CR) after one TACE p<0,001 There was a significant transient decrease in the mean platelet level after TACE (p=0.006). 255 treatment naive patients Resection 11 patients RFA 24 patients Sorafenib 45 patients TACE 90 patients LT 48 patients Intraop. RFA 14 patients Percut. RFA 10 patients BSC 50 patients Lipiodol 62 patients DEBDOX 28 patients CONCLUSIONS Therapeutic interventions should be decided on a case by case analysis. Surgery has comparable outcome to RFA but is more invasive. TACE was the most frequent procedure performed on HCC patients in our center, and is was shown to be a safe and effective therapy.