ABSTRACT:
Background/Aims: Alpha-fetoprotein
(AFP) and des-gamma-carboxy prothrombin (DCP) have been used as diagnostic
tools for hepatocellular carcinoma (HCC). However, prediction of outcome using
AFP and DCP has not been elucidated. We investigated the clinical role of AFP
and DCP as predictors of treatment outcome in patients with HCC undergoing
trans-arterial chemoembolization (TACE).
METHODS:
Between January 2003 and December
2005, we enrolled 115 treatment-naive patients who received TACE as an initial
treatment modality. An AFP or DCP response was defined as a reduction of more
than 50% from the baseline level 1 month after TACE. Patients with AFP < 20
ng/mL or DCP < 20 mAU/mL were excluded.
RESULTS:
The median age was 59 years and the
male gender predominated (n = 81, 70.4%). AFP and DCP response was identified
in 91 (79.1%) and 77 (66.9%) patients after TACE. Although progression-free
survival (PFS) did not differ according to AFP response (P = 0.150), AFP
responders showed significantly better overall survival (OS) than
non-responders (34.9 vs. 13.2 months; P = 0.002). In contrast, DCP response did
not influence either PFS or OS (all P > 0.05). Multivariate analyses showed
that gamma-glutamyltranspeptidase and baseline AFP were predictors of PFS (all
P < 0.05) and that male gender, the presence of liver cirrhosis, baseline
DCP, number of measurable tumors and AFP response were independent predictors
of OS (all P < 0.05).
CONCLUSIONS:
AFP response and higher baseline DCP
level are significant predictors of OS in treatment-naive patients with HCC
receiving TACE who showed pretreatment elevation of both AFP and DCP.
Source: Prognostic value of
alpha-fetoprotein and des-gamma-carboxy prothrombin responses in patients with
hepatocellular carcinoma treated with transarterial chemoembolization. Lee YK,
Kim SU, Kim DY, Ahn SH, Lee KH, Lee DY, Han KH, Chon CY, Park JY (DRPJY@yuhs.ac). BMC Cancer. 2013 Jan 3;13(1):5.
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