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Favorable α‐fetoprotein decrease as a prognostic surrogate in patients with hepatocellular carcinoma after radiofrequency ablation
Author(s) -
Tsai MingChao,
Wang JingHoung,
Hung ChaoHung,
Kee KwongMing,
Yen YiHao,
Lee ChuanMo,
Hu TsungHui,
Chen ChienHung,
Lu ShengNan
Publication year - 2010
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2009.06115.x
Subject(s) - medicine , hepatocellular carcinoma , radiofrequency ablation , alpha fetoprotein , radiological weapon , gastroenterology , ablation , radiology , nuclear medicine
Background and Aim: To assess the significance of adequate α‐fetoprotein decrease in monitoring the treatment effects of radiofrequency ablation (RFA) in hepatocellular carcinoma (HCC) patients. Methods: A total of 72 RFA treatments in 54 HCC patients were analyzed. The favorable α‐fetoprotein decrease was defined as the α‐fetoprotein half‐life of less than 7 days. The efficacy of the ablation response is assessed by standard imaging modality, a computed tomography scan 1 month after RFA. We assessed the correlation between different α‐fetoprotein decreases and treatment outcomes by standard imaging modality. Results: Of the 72 therapies, 15 (21%) were favorable α‐fetoprotein decreases. Fifty‐one (71%) therapies showed concordant results through standard image modality and α‐fetoprotein decrease, including 14 (27%) therapies with a complete radiological response and favorable α‐fetoprotein decrease, and the remaining 37 (73%) therapies with an incomplete radiological response and unfavorable α‐fetoprotein decrease. The accuracy was 70.8% by using α‐fetoprotein decrease in the detection treatment response based on a complete radiological response. Among the 34 therapies with a complete radiological response, 14 therapies with a favorable α‐fetoprotein decrease had a better disease‐free survival curve than 20 therapies with an unfavorable α‐fetoprotein decrease ( P = 0.003). Only one case had a favorable α‐fetoprotein decrease, but incomplete radiological response, with massive necrosis, with the exception of a small residual tumor. Conclusions: A favorable α‐fetoprotein decrease has better predictive power for disease‐free survival than for an unfavorable α‐fetoprotein decrease. HCC patients after RFA with an unfavorable α‐fetoprotein decrease should be considered to have undergone incomplete treatment, despite the complete response by standard image modality post‐RFA.