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Clinical usefulness of double biomarkers AFP and PIVKA ‐ II for subdividing prognostic groups in locally advanced hepatocellular carcinoma
Author(s) -
Park Hana,
Kim Seung Up,
Park Jun Young,
Kim Do Young,
Ahn Sang Hoon,
Chon Chae Yoon,
Han KwangHyub,
Seong Jinsil
Publication year - 2014
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.12274
Subject(s) - hepatocellular carcinoma , medicine , gastroenterology , complete response , biomarker , overall survival , oncology , chemotherapy , biology , biochemistry
Background & Aims In this study, we investigated the clinical usefulness of AFP and PIVKA ‐ II in subdividing prognostic groups in patients with locally advanced HCC treated locally. Methods Patients who had undergone local treatment for locally advanced HCC between 2001 and 2006 were enrolled. Response to treatment was defined as a reduction in AFP or PIVKA ‐ II by more than 50% from baseline levels at 1 month after the treatment completion. Patients were divided according to their AFP and PIVKA ‐ II response: A↓P↓ [ AFP response (+) and PIVKA ‐ II response (+)]; A↓P↑ [ AFP response (+) and PIVKA ‐ II response (−)]; A↑P↓ [ AFP response (−) and PIVKA ‐ II response (+)]; A↑P↑ [ AFP response (−) and PIVKA ‐ II response (−)]. Clinical characteristics and prognosis were compared between groups. Results Patients were subdivided into four groups by the change in the level of the biomarkers AFP and PIVKA ‐ II , and the survival outcomes of each group were distinct. Among patients with an AFP response, further subdivision by PIVKA ‐ II response revealed that those in the A↓P↓ group had a longer median progression‐free survival ( PFS ) and overall survival ( OS ) compared with those in the A↓P↑ group ( PFS : 16.2 vs. 5.1 months, P = 0.009; OS : 26.3 vs. 7.3 months, P = 0.017). Combination of AFP and PIVKA ‐ II response showed a predictive power for PFS and OS comparable to radiological criteria and better than AFP response alone. Conclusions In patients with locally advanced HCC , the use of a combination of two biomarkers, AFP and PIVKA ‐ II , appears useful in predicting treatment outcomes through the subdivision of prognostic groups.