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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
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]