Serum alpha-fetoprotein response can predict prognosis in hepatocellular carcinoma patients undergoing radiofrequency ablation therapy

• Published in: Clinical radiology 2012-05, Vol.67 (5), p.429-436
• Main Authors: Kao, W.-Y, Chiou, Y.-Y, Hung, H.-H, Su, C.-W, Chou, Y.-H, Wu, J.-C, Huo, T.-I, Huang, Y.-H, Wu, W.-C, Lin, H.-C, Lee, S.-D
• Format: Article
• Language: English
• Subjects: Aged; alpha-Fetoproteins - metabolism; Biological and medical sciences; Biomarkers, Tumor - blood; Carcinoma, Hepatocellular - blood; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - surgery; Catheter Ablation - methods; Female; Follow-Up Studies; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Investigative techniques, diagnostic techniques (general aspects); Liver Neoplasms - blood; Liver Neoplasms - mortality; Liver Neoplasms - surgery; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Prognosis; Radiology; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Retrospective Studies; Risk Factors; Survival Rate; Treatment Outcome; Tumors
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2011.10.009

Aims To evaluate the clinical inference of serum alpha-fetoprotein (AFP) response in hepatocellular carcinoma (HCC) patients undergoing percutaneous radiofrequency ablation (RFA). Materials and methods Three hundred and thirteen previously untreated HCC patients were enrolled in the study. The optimal AFP response was defined as >20% decrease from baseline after 1 month of RFA for those with a baseline AFP level of ≥100 ng/ml. The impact of AFP response on prognosis was analysed and prognostic factors were assessed. Results After a median follow-up of 26.7 ± 19.1 months, 49 patients died and 264 patients were alive. The cumulative 5 year survival rates were 75.3 and 57.4% in patients with an initial AFP of 1.1 ( p  = 0.009), non-optimal AFP response ( p  = 0.023), and creatinine >1.5 mg/dl ( p  = 0.021) were independent risk factors predictive of poor overall survival. Besides, the cumulative 5 year recurrence rates were 83.4 and 100% in optimal and non-optimal AFP responders, respectively ( p  2 cm ( p  = 0.027), and non-optimal AFP response ( p