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Post‐ablation des‐gamma‐carboxy prothrombin level predicts prognosis in hepatitis B‐related hepatocellular carcinoma
Author(s) -
Lee Sunyoung,
Rhim Hyunchul,
Kim Youngsun,
Kang Tae Wook,
Song Kyoung Doo
Publication year - 2016
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.12991
Subject(s) - medicine , hepatocellular carcinoma , gastroenterology , hazard ratio , liver cancer , radiofrequency ablation , stage (stratigraphy) , univariate analysis , ablation , proportional hazards model , prothrombin time , confidence interval , hepatitis b , cancer , survival analysis , multivariate analysis , paleontology , biology
Background & Aims We investigated whether pre‐ or post‐ablation serum alpha‐foetoprotein ( AFP ) and des‐gamma‐carboxy prothrombin ( DCP ) levels can predict prognosis in patients with curative radiofrequency ablation ( RFA ) for hepatitis B virus ( HBV )‐related hepatocellular carcinoma ( HCC ). Methods We retrospectively analysed 412 patients with HBV ‐related single HCC treated with percutaneous RFA between January 2004 and December 2013. AFP and DCP levels were measured before (pre‐ablation) and 1 month after treatment (post‐ablation). We assessed predictive factors for overall and recurrence‐free survival. Results On univariate analysis, Child‐Pugh score, Model for End‐Stage Liver Disease (MELD) score, platelet count, tumour size, Barcelona Clinic Liver Cancer ( BCLC ) stage, and pre‐ and post‐ablation DCP were significant for overall survival; and age, Child‐Pugh score, MELD score, platelet count, tumour size, Cancer of the Liver Italian Program ( CLIP ) score, BCLC stage, and pre‐ and post‐ablation AFP and DCP were significant for recurrence‐free survival. Multivariate analysis revealed significant differences in overall survival by MELD score and tumour size and in recurrence‐free survival by BCLC stage. Among the tumour markers, post‐ablation DCP was an independent prognostic factor for overall and recurrence‐free survival [hazard ratio ( HR ), 3.438; 95% confidence interval ( CI ), 1.331–8.877; P = 0.011 and HR , 4.934; 95% CI , 2.761–8.816; P < 0.001 respectively]. Post‐ablation AFP was associated with recurrence‐free survival ( HR , 1.995; 95% CI , 1.476–2.697; P < 0.001) but not overall survival. Conclusions In patients with HBV ‐related HCC , post‐ablation serum DCP is a useful biomarker for predicting survival and recurrence after curative RFA .