Early on-treatment predictions of clinical outcomes using alpha-fetoprotein and des-gamma-carboxy prothrombin responses in patients with advanced hepatocellular carcinoma

Myoung Ha Lee, Seung Up Kim, Do Young Kim, Sang Hoon Ahn, Eun Hee Choi, Kwang Hun Lee, Do Yun Lee, Jinsil Seong, Kwang Hyub Han, Chae Yoon Chon, Jun Yong Park

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23 Citations (Scopus)

Abstract

Background and Aim: The clinical utility of alpha-fetoprotein (AFP) and des-γ-carboxy prothrombin (DCP) as a predictor of treatment outcome in patients with advanced hepatocellular carcinoma (HCC) receiving hepatic artery infusional chemotherapy (HAIC) or concurrent chemoradiation therapy (CCRT) has been poorly defined. Methods: Between January 2003 and December 2007, we enrolled 127 treatment-naïve patients who received HAIC (n=60) or CCRT (n=67) as an initial treatment modality. An AFP or DCP response was defined as a reduction of more than 20% from the baseline level. Results: AFP responders showed significantly better overall survival (OS) than non-responders among patients with HAIC (median 17.3 vs 6.4months, P<0.001) and with CCRT (median 17.6 vs 8.7months, P=0.014). DCP responders in the CCRT group also showed significantly better progression-free survival (PFS) than non-responders (median 9.2 vs 3.1months, P<0.001). Multivariate Cox regression analyses showed that AFP response was independently predictive of OS in both groups (P=0.009 in HAIC and P=0.008 in CCRT) whereas DCP only predicted PFS in patients with CCRT (P=0.015). Conclusions: Early on-treatment AFP response was predictive of OS in treatment-naïve patients with advanced HCC receiving HAIC and CCRT as an initial treatment modality. Furthermore, DCP response was useful for predicting PFS in patients with CCRT.

Original languageEnglish
Pages (from-to)313-322
Number of pages10
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume27
Issue number2
DOIs
Publication statusPublished - 2012 Feb

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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