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

Authors
 Yong Kang Lee ; Seung Up Kim ; Jun Yong Park ; Chae Yoon Chon ; Kwang-Hyub Han ; Do Yun Lee ; Kwang Hun Lee ; Sang Hoon Ahn ; Do Young Kim 
Citation
 BMC Cancer, Vol.13 : 5, 2013 
Journal Title
 BMC Cancer 
ISSN
 1471-2407 
Issue Date
2013
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.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/86450
DOI
10.1186/1471-2407-13-5
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Radiology
1. 연구논문 > 1. College of Medicine > Dept. of Dermatology
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
Yonsei Authors
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