Alpha-Fetoprotein, Des-Gamma-Carboxy Prothrombin, and Modified RECIST Response as Predictors of Survival after Transarterial Radioembolization for Hepatocellular Carcinoma

Tae Seop Lim, Hyungjin Rhee, Gyoung Min Kim, Seung Up Kim, Beom Kyung Kim, Jun Yong Park, Sang Hoon Ahn, Kwang Hyub Han, Jin Young Choi, Do Young Kim

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate the prognostic role of alpha-fetoprotein (AFP), des-gamma-carboxy protein (DCP), and modified Response Evaluation Criteria in Solid Tumors (mRECIST) in patients with hepatocellular carcinoma after transarterial radioembolization (TARE). Materials and Methods: During 2009–2016, 63 patients with AFP >20 ng/mL, DCP >20 mAU/mL, and Child-Pugh class A who were treated with TARE were evaluated using landmark and risk-of-death method after TARE. Both resin microspheres (n = 46) and glass microspheres (n = 17) were used. AFP or DCP response was defined as more than 50% decrease from baseline. mRECIST response was defined as complete or partial response. Median age was 60 years, and the proportion of male sex was 77.8% (n = 49). The proportions of patients with Barcelona Clinic Liver Cancer stages A, B, and C were 7.9% (n = 5), 46.0% (n = 29), and 46.0% (n = 29), respectively. Results: At the 3-month landmark, AFP, DCP, and mRECIST responders lived longer than nonresponders (median overall survival, 75.8 vs 7.6 months for AFP; 75.8 vs 7.1 months for DCP; and 75.8 vs 10.0 months for mRECIST; all P <.05). The 6-month risk of death at the 3-month landmark was statistically different only between DCP responders and nonresponders (P =.002). In multivariate analysis, age less than 70 years (P =.024), absence of distant metastasis (P =.049), DCP response (P =.003), and mRECIST response (P =.003) were independent predictors for overall survival at the 3-month landmark after TARE. Conclusions: AFP, DCP, and mRECIST responders showed better prognosis than nonresponders after TARE, and DCP response was a more potent predictor than AFP response. Tumor marker response, as well as radiologic response, may be useful to predict post-TARE survival.

Original languageEnglish
Pages (from-to)1194-1200.e1
JournalJournal of Vascular and Interventional Radiology
Volume30
Issue number8
DOIs
Publication statusPublished - 2019 Aug

Fingerprint

alpha-Fetoproteins
Hepatocellular Carcinoma
Survival
Proteins
Microspheres
Response Evaluation Criteria in Solid Tumors
acarboxyprothrombin
Liver Neoplasms
Tumor Biomarkers
Glass
Multivariate Analysis
Neoplasm Metastasis

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

@article{ca7fbdfc78644f92996b64cbe13508df,
title = "Alpha-Fetoprotein, Des-Gamma-Carboxy Prothrombin, and Modified RECIST Response as Predictors of Survival after Transarterial Radioembolization for Hepatocellular Carcinoma",
abstract = "Purpose: To evaluate the prognostic role of alpha-fetoprotein (AFP), des-gamma-carboxy protein (DCP), and modified Response Evaluation Criteria in Solid Tumors (mRECIST) in patients with hepatocellular carcinoma after transarterial radioembolization (TARE). Materials and Methods: During 2009–2016, 63 patients with AFP >20 ng/mL, DCP >20 mAU/mL, and Child-Pugh class A who were treated with TARE were evaluated using landmark and risk-of-death method after TARE. Both resin microspheres (n = 46) and glass microspheres (n = 17) were used. AFP or DCP response was defined as more than 50{\%} decrease from baseline. mRECIST response was defined as complete or partial response. Median age was 60 years, and the proportion of male sex was 77.8{\%} (n = 49). The proportions of patients with Barcelona Clinic Liver Cancer stages A, B, and C were 7.9{\%} (n = 5), 46.0{\%} (n = 29), and 46.0{\%} (n = 29), respectively. Results: At the 3-month landmark, AFP, DCP, and mRECIST responders lived longer than nonresponders (median overall survival, 75.8 vs 7.6 months for AFP; 75.8 vs 7.1 months for DCP; and 75.8 vs 10.0 months for mRECIST; all P <.05). The 6-month risk of death at the 3-month landmark was statistically different only between DCP responders and nonresponders (P =.002). In multivariate analysis, age less than 70 years (P =.024), absence of distant metastasis (P =.049), DCP response (P =.003), and mRECIST response (P =.003) were independent predictors for overall survival at the 3-month landmark after TARE. Conclusions: AFP, DCP, and mRECIST responders showed better prognosis than nonresponders after TARE, and DCP response was a more potent predictor than AFP response. Tumor marker response, as well as radiologic response, may be useful to predict post-TARE survival.",
author = "Lim, {Tae Seop} and Hyungjin Rhee and Kim, {Gyoung Min} and Kim, {Seung Up} and Kim, {Beom Kyung} and Park, {Jun Yong} and Ahn, {Sang Hoon} and Han, {Kwang Hyub} and Choi, {Jin Young} and Kim, {Do Young}",
year = "2019",
month = "8",
doi = "10.1016/j.jvir.2019.03.016",
language = "English",
volume = "30",
pages = "1194--1200.e1",
journal = "Journal of Vascular and Interventional Radiology",
issn = "1051-0443",
publisher = "Elsevier Inc.",
number = "8",

}

TY - JOUR

T1 - Alpha-Fetoprotein, Des-Gamma-Carboxy Prothrombin, and Modified RECIST Response as Predictors of Survival after Transarterial Radioembolization for Hepatocellular Carcinoma

AU - Lim, Tae Seop

AU - Rhee, Hyungjin

AU - Kim, Gyoung Min

AU - Kim, Seung Up

AU - Kim, Beom Kyung

AU - Park, Jun Yong

AU - Ahn, Sang Hoon

AU - Han, Kwang Hyub

AU - Choi, Jin Young

AU - Kim, Do Young

PY - 2019/8

Y1 - 2019/8

N2 - Purpose: To evaluate the prognostic role of alpha-fetoprotein (AFP), des-gamma-carboxy protein (DCP), and modified Response Evaluation Criteria in Solid Tumors (mRECIST) in patients with hepatocellular carcinoma after transarterial radioembolization (TARE). Materials and Methods: During 2009–2016, 63 patients with AFP >20 ng/mL, DCP >20 mAU/mL, and Child-Pugh class A who were treated with TARE were evaluated using landmark and risk-of-death method after TARE. Both resin microspheres (n = 46) and glass microspheres (n = 17) were used. AFP or DCP response was defined as more than 50% decrease from baseline. mRECIST response was defined as complete or partial response. Median age was 60 years, and the proportion of male sex was 77.8% (n = 49). The proportions of patients with Barcelona Clinic Liver Cancer stages A, B, and C were 7.9% (n = 5), 46.0% (n = 29), and 46.0% (n = 29), respectively. Results: At the 3-month landmark, AFP, DCP, and mRECIST responders lived longer than nonresponders (median overall survival, 75.8 vs 7.6 months for AFP; 75.8 vs 7.1 months for DCP; and 75.8 vs 10.0 months for mRECIST; all P <.05). The 6-month risk of death at the 3-month landmark was statistically different only between DCP responders and nonresponders (P =.002). In multivariate analysis, age less than 70 years (P =.024), absence of distant metastasis (P =.049), DCP response (P =.003), and mRECIST response (P =.003) were independent predictors for overall survival at the 3-month landmark after TARE. Conclusions: AFP, DCP, and mRECIST responders showed better prognosis than nonresponders after TARE, and DCP response was a more potent predictor than AFP response. Tumor marker response, as well as radiologic response, may be useful to predict post-TARE survival.

AB - Purpose: To evaluate the prognostic role of alpha-fetoprotein (AFP), des-gamma-carboxy protein (DCP), and modified Response Evaluation Criteria in Solid Tumors (mRECIST) in patients with hepatocellular carcinoma after transarterial radioembolization (TARE). Materials and Methods: During 2009–2016, 63 patients with AFP >20 ng/mL, DCP >20 mAU/mL, and Child-Pugh class A who were treated with TARE were evaluated using landmark and risk-of-death method after TARE. Both resin microspheres (n = 46) and glass microspheres (n = 17) were used. AFP or DCP response was defined as more than 50% decrease from baseline. mRECIST response was defined as complete or partial response. Median age was 60 years, and the proportion of male sex was 77.8% (n = 49). The proportions of patients with Barcelona Clinic Liver Cancer stages A, B, and C were 7.9% (n = 5), 46.0% (n = 29), and 46.0% (n = 29), respectively. Results: At the 3-month landmark, AFP, DCP, and mRECIST responders lived longer than nonresponders (median overall survival, 75.8 vs 7.6 months for AFP; 75.8 vs 7.1 months for DCP; and 75.8 vs 10.0 months for mRECIST; all P <.05). The 6-month risk of death at the 3-month landmark was statistically different only between DCP responders and nonresponders (P =.002). In multivariate analysis, age less than 70 years (P =.024), absence of distant metastasis (P =.049), DCP response (P =.003), and mRECIST response (P =.003) were independent predictors for overall survival at the 3-month landmark after TARE. Conclusions: AFP, DCP, and mRECIST responders showed better prognosis than nonresponders after TARE, and DCP response was a more potent predictor than AFP response. Tumor marker response, as well as radiologic response, may be useful to predict post-TARE survival.

UR - http://www.scopus.com/inward/record.url?scp=85067423962&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85067423962&partnerID=8YFLogxK

U2 - 10.1016/j.jvir.2019.03.016

DO - 10.1016/j.jvir.2019.03.016

M3 - Article

C2 - 31235408

AN - SCOPUS:85067423962

VL - 30

SP - 1194-1200.e1

JO - Journal of Vascular and Interventional Radiology

JF - Journal of Vascular and Interventional Radiology

SN - 1051-0443

IS - 8

ER -