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Background and Study Aims: Percutaneous liver biopsy is traditionally done from right-lobe of liver. Endoscopic-ultrasound guided liver biopsy (EUS-LB) can be performed from either left- or the right-lobe or combined bi-lobar biopsy. Earlier studies did not compare benefit of bi-lobar biopsies to single lobe biopsy for reaching a tissue diagnosis. The current study compares the degree of agreement of pathological diagnosis between left-lobe of liver compared to right- and with bi-lobar biopsy. Patients and Methods: Fifty patients fulfilling the inclusion criteria were enrolled in the study. EUS-LB with 22G core needle was taken separately from both the liver lobes. Three pathologists, who were blinded to the site of biopsy independently reviewed the liver biopsies. Sample adequacy, safety, and concordance of pathological diagnosis between left- and right lobe biopsy of liver were analyzed. Results: The pathological diagnosis was made in 96% patients. Specimen length from the left-lobe and the right-lobe were 2.31  0.57cms and 2.28  0.69cms respectively (p-value = 0.476). The respective number of portal tracts were 11.84  6.71 versus 9.58  7.14; p-value= 0.106. Diagnosis between the two lobes showed substantial (Kappa value  0.830) concordance. Left-lobe ( value 0.878) or the right-lobe ( value 0.903) biopsies showed no difference when compared with bi-lobar biopsies. Adverse events were observed in 2 patients, both in biopsy from right-lobe. Conclusions: EUS guided left lobe liver biopsy is more safer to right lobe biopsies with similar diagnostic yield.

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analyzed, pre-treatment AFP<10ng/ml and post-treatment AFP response50% at 1 month yielded the best estimated 5-year survival (p=0.002) -(IDDF2021-ABS-0088 Figure 1. Kaplan-Meier Curve for Overall Survival of HCC Patients based on Pre-treatment AFP and Post-treatment AFP response 50% at 1 month after RFA). Conclusions Pre-treatment AFP<10ng/ml, 6-months post-treatment AFP response50% with normal AFP and 1-and 3months post-treatment AFP response50% with high AFP were predictors of better OS. AFP<10ng/mL at any time during 1-,3-or 6-months after RFA was an important predictor of better prognosis. The best prognosticator for OS was a patient with pre-treatment AFP<10ng/ml and post-treatment AFP response50% at 1 month.