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Serum ferritin as a new prognostic factor in hepatocellular carcinoma patients treated with radiofrequency ablation
Author(s) -
Facciorusso Antonio,
Del Prete Valentina,
Antonino Matteo,
Neve Viviana,
Crucinio Nicola,
Di Leo Alfredo,
Carr Brian I,
Barone Michele
Publication year - 2014
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/jgh.12618
Subject(s) - medicine , gastroenterology , hepatocellular carcinoma , radiofrequency ablation , stage (stratigraphy) , proportional hazards model , univariate analysis , multivariate analysis , ferritin , ablation , biology , paleontology
Abstract Background and Aim Hepatic iron accumulation is considered to be a cofactor that influences liver injury and hepatocarcinogenesis. Aim of this study is to determine whether serum ferritin ( SF ) levels relate to overall survival ( OS ) and time to recurrence ( TTR ) in hepatocellular carcinoma ( HCC ) patients treated with percutaneous radiofrequency ablation ( RFA ). Methods We measured SF levels in 103 HCC patients (median age 70, M / F = 82.5%/17.5%) who underwent RFA between 2005 and 2010. Correlation between SF and other prognostic factors at baseline was analyzed. SF levels were entered into a C ox model and their influence on OS and TTR was evaluated in univariate and multivariate analyses. Results SF did not correlate with α‐fetoprotein (rho: −0.12, P = 0.22), neutrophil/lymphocyte ratio (rho: −0.1020, P = 0.30), Model for End‐Stage Liver Disease (rho: 0.18, P = 0.06), Child‐Pugh score ( P = 0.5), or Barcelona Cancer of the Liver Clinic stage ( P = 0.16). A log‐rank test found the value of 244 ng/mL as the optimal prognostic cut‐off point for SF . Median OS was 62 months (54–78) and survival rate was 97%, 65%, and 52% at 1, 4, and 5 years, respectively. Performance status and SF were the only predictors of OS at multivariate analysis. Median TTR was 38 months (34–49) with a recurrence‐free survival rate of 82.5%, 26.2%, and 23.3% at 1, 4, and 5 years, respectively, while SF and age were the only predictors of TTR . Conclusions SF level, possibly reflecting the degree of hepatic inflammation and fibrosis, is a negative risk factor for survival and recurrence after percutaneous RFA in HCC patients.