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Preoperative tumor marker doubling time is a useful predictor of recurrence and prognosis after hepatic resection of hepatocellular carcinoma
Author(s) -
Masuda Toshiro,
Beppu Toru,
Horino Kei,
Komori Hiroyuki,
Hayashi Hiromitsu,
Okabe Hirohisa,
Otao Ryu,
Horlad Hasita,
Ishiko Takatoshi,
Takamori Hiroshi,
Kikuchi Ken,
Baba Hideo
Publication year - 2009
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21451
Subject(s) - medicine , doubling time , hepatocellular carcinoma , hepatectomy , gastroenterology , alpha fetoprotein , carcinoma , surgery , resection , oncology , chemistry , biochemistry , in vitro
Abstract Background and Objectives It is important to identify prognostic factors in patients with hepatocellular carcinoma (HCC) before hepatectomy. No previous studies have addressed the predictive efficacy of the preoperative doubling times of alpha‐fetoprotein (AFP) and protein induced by vitamin K absence (PIVKA‐II). Methods A total of 210 HCC patients who underwent a hepatic resection between 1998 and 2006 were prospectively evaluated. Serum AFP and PIVKA‐II levels were measured at least twice before surgery to calculate the doubling times. Nineteen clinical factors that can be examined preoperatively, including the doubling times of AFP and PIVKA‐II were investigated to identify prognostic factors for disease‐free and overall survival after hepatectomy. Results There was no relationship between preoperative levels and doubling times of AFP and PIVKA‐II. In a multivariate analysis, patients with a doubling time of AFP ≤30 days and PIVKA‐II ≤16 days showed a significantly worse disease‐free ( P = 0.02, P = 0.03, respectively) and overall survival ( P < 0.0001, P = 0.03, respectively). Conclusions In HCC patients, the doubling times of preoperative serum AFP or PIVKA‐II levels are useful tools to predict early postoperative recurrence and a poor prognosis. J. Surg. Oncol. 2010;102:490–496. © 2009 Wiley‐Liss, Inc.