Prognostic value of α-fetoprotein and des-γ-carboxy prothrombin responses in patients with hepatocellular carcinoma treated with transarterial chemoembolization

Yong Kang Lee, Seung Up Kim, Do Young Kim, Sang Hoon Ahn, Kwang Hun Lee, Do Yun Lee, Kwang Hyub Han, Chae Yoon Chon, Jun Yong Park

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33 Citations (Scopus)

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-naïve 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-naïve patients with HCC receiving TACE who showed pretreatment elevation of both AFP and DCP.

Original languageEnglish
Article number5
JournalBMC cancer
Volume13
DOIs
Publication statusPublished - 2013 Jan 3

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Fetal Proteins
alpha-Fetoproteins
Prothrombin
Hepatocellular Carcinoma
acarboxyprothrombin
Liver Cirrhosis
Therapeutics
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Genetics
  • Oncology
  • Cancer Research

Cite this

@article{1a2569c4be8d40599c5072776f2f71af,
title = "Prognostic value of α-fetoprotein and des-γ-carboxy prothrombin responses in patients with hepatocellular carcinoma treated with transarterial chemoembolization",
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-na{\"i}ve 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-na{\"i}ve patients with HCC receiving TACE who showed pretreatment elevation of both AFP and DCP.",
author = "Lee, {Yong Kang} and Kim, {Seung Up} and Kim, {Do Young} and Ahn, {Sang Hoon} and Lee, {Kwang Hun} and Lee, {Do Yun} and Han, {Kwang Hyub} and Chon, {Chae Yoon} and Park, {Jun Yong}",
year = "2013",
month = "1",
day = "3",
doi = "10.1186/1471-2407-13-5",
language = "English",
volume = "13",
journal = "BMC Cancer",
issn = "1471-2407",
publisher = "BioMed Central",

}

TY - JOUR

T1 - Prognostic value of α-fetoprotein and des-γ-carboxy prothrombin responses in patients with hepatocellular carcinoma treated with transarterial chemoembolization

AU - Lee, Yong Kang

AU - Kim, Seung Up

AU - Kim, Do Young

AU - Ahn, Sang Hoon

AU - Lee, Kwang Hun

AU - Lee, Do Yun

AU - Han, Kwang Hyub

AU - Chon, Chae Yoon

AU - Park, Jun Yong

PY - 2013/1/3

Y1 - 2013/1/3

N2 - 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-naïve 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-naïve patients with HCC receiving TACE who showed pretreatment elevation of both AFP and DCP.

AB - 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-naïve 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-naïve patients with HCC receiving TACE who showed pretreatment elevation of both AFP and DCP.

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U2 - 10.1186/1471-2407-13-5

DO - 10.1186/1471-2407-13-5

M3 - Article

C2 - 23282286

AN - SCOPUS:84871721351

VL - 13

JO - BMC Cancer

JF - BMC Cancer

SN - 1471-2407

M1 - 5

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