Premium
Evaluation of a serum tumour marker‐based recurrence prediction model after radiofrequency ablation for hepatocellular carcinoma
Author(s) -
Yoo Jeongin,
Lee Min Woo,
Lee Dong Ho,
Lee JeongHoon,
Han Joon Koo
Publication year - 2020
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.14406
Subject(s) - medicine , hepatocellular carcinoma , cohort , radiofrequency ablation , hazard ratio , gastroenterology , oncology , proportional hazards model , ablation , confidence interval
Abstract Background & aims A recent study showed that serum tumour marker‐based MoRAL score (11×√protein induced by vitamin K absence‐II [PIVKA] +2×√alpha‐foetoprotein [AFP]) can reflect both tumour burden and aggressiveness of hepatocellular carcinoma (HCC). This study aimed to evaluate whether baseline MoRAL score could predict tumour recurrence after radiofrequency ablation (RFA) for very‐early/early‐stage HCC. Methods A total of 576 HCC patients who underwent RFA as initial treatment were enrolled from two tertiary referral hospitals (256 in development cohort and 320 in validation cohort). The primary endpoint was recurrence‐free survival (RFS) and the secondary endpoints included cumulative risks of intrahepatic distant recurrence (IDR) and extrahepatic metastasis (EM). Results In the development cohort, MoRAL score was an independent prognostic factor of RFS ( P = .02). The optimal cutoff MoRAL score for predicting RFS was 68. Patients with high MoRAL score (>68) showed significantly shorter RFS than did those with low MoRAL score (hazard ratio [HR] = 2.04, P < .001). The 5‐year RFS rates were 32.3% and 53.2% in high‐ and low‐MoRAL groups respectively. Risks of both IDR (HR = 1.76, P = .003) and EM (HR = 8.25, P = .006) were also significantly higher in high MoRAL group. These results were reproduced in the validation cohort: RFS (HR = 1.81, P < .001; 5‐year RFS rates = 27.7% vs 53.6%) was significantly shorter and risks of IDR (HR = 1.59, P = .003) and EM (HR = 6.19, P = .004) were significantly higher in high MoRAL group. Conclusion A high MoRAL score of >68 was significant a predictive factor of tumour recurrence after RFA for very‐early/early‐stage HCC. Moreover, it might be warranted to evaluate EM in patients with high baseline MoRAL scores.