Premium
Clinical significance of half‐lives of tumor markers α‐fetoprotein and des‐γ‐carboxy prothrombin after hepatectomy for hepatocellular carcinoma
Author(s) -
Tsukamoto Masayo,
Nitta Hidetoshi,
Imai Katsunori,
Higashi Takaaki,
Nakagawa Shigeki,
Okabe Hirohisa,
Arima Kota,
Kaida Takayoshi,
Taki Katsunobu,
Hashimoto Daisuke,
Chikamoto Akira,
Ishiko Takatoshi,
Beppu Toru,
Baba Hideo
Publication year - 2018
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12942
Subject(s) - hepatectomy , hepatocellular carcinoma , medicine , gastroenterology , hazard ratio , clinical significance , cohort , alpha fetoprotein , surgery , resection , confidence interval
Aim The prognostic significance of the half‐lives (HLs) of α‐fetoprotein (AFP) and des‐γ‐carboxy prothrombin (DCP) in patients undergoing hepatectomy for hepatocellular carcinoma (HCC) is unclear. We evaluated the HLs of AFP and DCP in a cohort of such patients. Methods This study included data on 202 patients with HCC who underwent curative hepatectomy and had preoperative AFP concentrations ≥100 ng/mL or DCP ≥200 mAU/mL. We calculated the HLs of AFP and DCP from their values just before and 1 month after hepatectomy. We identified three groups: a normalization group, tumor marker concentrations within normal range 1 month post‐hepatectomy; a long group, HL of AFP ≥7 days or DCP ≥4 days; and a short group, remaining patients. We evaluated associations between HL and prognosis. Results Three‐year recurrence‐free survival (RFS) in the normalization ( n = 70), short ( n = 71), and long groups ( n = 61) was 41.3%, 46.0%, and 16.8%, respectively ( P = 0.002). Five‐year overall survival (OS) of normalization, short, and long groups was 72.6, 70.6 and 43.8%, respectively ( P = 0.002). Multivariate analysis revealed that long HL is an independent risk factor for poor RFS (hazard ratio [HR] 2.21, P = 0.0006) and poor OS (HR 2.70, P = 0.004). The extrahepatic recurrence rate was 21.3% (13/61) in the long group, which is higher than in the normalization group (8.6%, 6/70) ( P = 0.04) and short group (9.9%, 7/71) ( P = 0.07). Conclusion Post‐hepatectomy HLs of AFP and DCP are predictors of long‐term outcome in patients with HCC.