Prognostic Value of Alpha-Fetoprotein in Patients Who Achieve a Complete Response to Transarterial Chemoembolization for Hepatocellular Carcinoma
- 주제(키워드) Carcinoma , hepatocellular , alpha-fetoprotein , prognosis , treatment outcome , transarterial chemoembolization
- 주제(기타) Medicine, General & Internal
- 설명문(일반) [Lee, Jae Seung; Kim, Beom Kyung; Park, Jun Yong; Kim, Do Young; Ahn, Sang Hoon; Han, Kwang-Hyub; Kim, Seung Up] Yonsei Univ, Coll Med, Dept Internal Med, 50-1 Yonsei Ro, Seoul 03722, South Korea; [Lee, Jae Seung; Kim, Beom Kyung; Park, Jun Yong; Kim, Do Young; Ahn, Sang Hoon; Han, Kwang-Hyub] Severance Hosp, Yonsei Liver Ctr, Seoul, South Korea; [Chon, Young Eun; Ha, Yeonjung; Kim, Mi Na; Lee, Joo Ho; Hwang, Seong Gyu] CHA Univ, CHA Bundang Med Ctr, Dept Internal Med, Seongnam, South Korea; [Kang, Wonseok; Choi, Moon Seok; Gwak, Geum-Youn; Paik, Yong-Han; Lee, Joon Hyeok; Koh, Kwang Cheol; Paik, Seung Woon; Sinn, Dong Hyun] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Med, 81 Irwon Ro, Seoul 06351, South Korea; [Kim, Hwi Young; Kim, Tae Hun; Yoo, Kwon] Ewha Womans Univ, Coll Med, Dept Internal Med, Seoul, South Korea; [Kim, Soon Sun; Cho, Hyo Jung; Cheong, Jae Youn; Cho, Sung Won] Ajou Univ, Sch Med, Dept Gastroenterol, Suwon, South Korea; [Park, Seung Ha; Heo, Nae-Yun] Inje Univ, Haeundae Paik Hosp, Dept Internal Med, Busan, South Korea; [Hong, Young Mi; Yoon, Ki Tae; Cho, Mong] Pusan Natl Univ, Yangsan Hosp, Liver Ctr, Yangsan, South Korea; [Park, Jung Gil; Kang, Min Kyu] Yeungnam Univ, Med Ctr, Dept Internal Med, Daegu, South Korea; [Park, Soo Young; Kweon, Young Oh; Tak, Won Young; Jang, Se Young] Kyungpook Natl Univ, Sch Med, Dept Internal Med, Daegu, South Korea
- 등재 SCIE, SCOPUS, KCI등재
- OA유형 Green Published, gold
- 발행기관 YONSEI UNIV COLL MEDICINE
- 발행년도 2021
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000175421
- 본문언어 영어
- Published As http://dx.doi.org/10.3349/ymj.2021.62.1.12
- PubMed https://pubmed.ncbi.nlm.nih.gov/33381930
초록/요약
Purpose: Alpha-fetoprotein (AFP) is a prognostic marker for hepatocellular carcinoma (HCC). We investigated the prognostic value of AR levels in patients who achieved complete response (CR) to transarterial chemoembolization (TACE) for HCC. Materials and Methods: Between 2005 and 2018, 890 patients with HCC who achieved a CR to TACE were recruited. An MP responder was defined as a patient who showed elevated levels of APP (>10 ng/mL) during 'FACE, but showed normalization or a >50% reduction in AFP levels after achieving a CR. Results: Among the recruited patients, 569 (63.9%) with naive 11a: and 321 (36.1%) with recurrent HCC after complete resection were treated. Before TACE, 305 (34.3%) patients had multiple tumors, 219 (24.6%) had a maximal tumor size >3 cm, and 22 (2.5%) had portal vein tumor thrombosis. The median All' level after achieving a CR was 6.36 ng/mL. After a CR, 473 (53.1%) patients experienced recurrence, and 417 (46.9%) died [median progression-free survival (PFS) and overall survival (OS) of 1 6.3 and 62.8 months, respectively]. High AFT levels at CR (>20 ng/mL) were independently associated with a shorter PFS [hazard ratio (HR)=1.403] and OS (H R=1.2114), together with tumor multiplicity at 'FACE (H R=1.51.8 and 1.666, respectively). AR non-responders at CR (76.2%, n=359 of 471) showed a shorter PPS (median 10.5 months vs. 15.5 months, HR=1.375) and OS (median 41.4 months vs. 61.8 months, HR=1.424) than AFP responders (all p=0.001). Conclusion: High AFP levels and AFP non-responders were 'independently associated with poor outcomes after TACE. AFP holds clinical implications for detailed risk stratification upon achieving a CR after TACE.
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