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Prognostic Value of Alpha-Fetoprotein in Patients Who Achieve a Complete Response to Transarterial Chemoembolization for Hepatocellular Carcinoma.


ABSTRACT:

Purpose

Alpha-fetoprotein (AFP) is a prognostic marker for hepatocellular carcinoma (HCC). We investigated the prognostic value of AFP levels in patients who achieved complete response (CR) to transarterial chemoembolization (TACE) for HCC.

Materials and methods

Between 2005 and 2018, 890 patients with HCC who achieved a CR to TACE were recruited. An AFP responder was defined as a patient who showed elevated levels of AFP (>10 ng/mL) during TACE, but showed normalization or a >50% reduction in AFP levels after achieving a CR.

Results

Among the recruited patients, 569 (63.9%) with naïve HCC and 321 (36.1%) with recurrent HCC after complete resection were treated. Before TACE, 305 (34.3%) patients had multiple tumors, 219 (24.6%) had a maximal tumor size >3 cm, and 22 (2.5%) had portal vein tumor thrombosis. The median AFP level after achieving a CR was 6.36 ng/mL. After a CR, 473 (53.1%) patients experienced recurrence, and 417 (46.9%) died [median progression-free survival (PFS) and overall survival (OS) of 16.3 and 62.8 months, respectively]. High AFP levels at CR (>20 ng/mL) were independently associated with a shorter PFS [hazard ratio (HR)=1.403] and OS (HR=1.284), together with tumor multiplicity at TACE (HR=1.518 and 1.666, respectively). AFP non-responders at CR (76.2%, n=359 of 471) showed a shorter PFS (median 10.5 months vs. 15.5 months, HR=1.375) and OS (median 41.4 months vs. 61.8 months, HR=1.424) than AFP responders (all p=0.001).

Conclusion

High AFP levels and AFP non-responders were independently associated with poor outcomes after TACE. AFP holds clinical implications for detailed risk stratification upon achieving a CR after TACE.

SUBMITTER: Lee JS 

PROVIDER: S-EPMC7820452 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Prognostic Value of Alpha-Fetoprotein in Patients Who Achieve a Complete Response to Transarterial Chemoembolization for Hepatocellular Carcinoma.

Lee Jae Seung JS   Chon Young Eun YE   Kim Beom Kyung BK   Park Jun Yong JY   Kim Do Young DY   Ahn Sang Hoon SH   Han Kwang Hyub KH   Kang Wonseok W   Choi Moon Seok MS   Gwak Geum Youn GY   Paik Yong Han YH   Lee Joon Hyeok JH   Koh Kwang Cheol KC   Paik Seung Woon SW   Kim Hwi Young HY   Kim Tae Hun TH   Yoo Kwon K   Ha Yeonjung Y   Kim Mi Na MN   Lee Joo Ho JH   Hwang Seong Gyu SG   Kim Soon Sun SS   Cho Hyo Jung HJ   Cheong Jae Youn JY   Cho Sung Won SW   Park Seung Ha SH   Heo Nae Yun NY   Hong Young Mi YM   Yoon Ki Tae KT   Cho Mong M   Park Jung Gil JG   Kang Min Kyu MK   Park Soo Young SY   Kweon Young Oh YO   Tak Won Young WY   Jang Se Young SY   Sinn Dong Hyun DH   Kim Seung Up SU  

Yonsei medical journal 20210101 1


<h4>Purpose</h4>Alpha-fetoprotein (AFP) is a prognostic marker for hepatocellular carcinoma (HCC). We investigated the prognostic value of AFP levels in patients who achieved complete response (CR) to transarterial chemoembolization (TACE) for HCC.<h4>Materials and methods</h4>Between 2005 and 2018, 890 patients with HCC who achieved a CR to TACE were recruited. An AFP responder was defined as a patient who showed elevated levels of AFP (>10 ng/mL) during TACE, but showed normalization or a >50%  ...[more]

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