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Prognostic Value of Alpha-Fetoprotein in Patients Who Achieve a Complete Response to Transarterial Chemoembolization for Hepatocellular Carcinoma
- Title
- Prognostic Value of Alpha-Fetoprotein in Patients Who Achieve a Complete Response to Transarterial Chemoembolization for Hepatocellular Carcinoma
- Authors
- Lee, Jae Seung; Chon, Young Eun; Kim, Beom Kyung; Park, Jun Yong; Kim, Do Young; Ahn, Sang Hoon; Han, Kwang-Hyub; Kang, Wonseok; Choi, Moon Seok; Gwak, Geum-Youn; Paik, Yong-Han; Lee, Joon Hyeok; Koh, Kwang Cheol; Paik, Seung Woon; Kim, Hwi Young; Kim, Tae Hun; Yoo, Kwon; Ha, Yeonjung; Kim, Mi Na; Lee, Joo Ho; Hwang, Seong Gyu; Kim, Soon Sun; Cho, Hyo Jung; Cheong, Jae Youn; Cho, Sung Won; Park, Seung Ha; Heo, Nae-Yun; Hong, Young Mi; Yoon, Ki Tae; Cho, Mong; Park, Jung Gil; Kang, Min Kyu; Park, Soo Young; Kweon, Young Oh; Tak, Won Young; Jang, Se Young; Sinn, Dong Hyun; Kim, Seung Up|Korean TACE Study Grp
- Ewha Authors
- 유권; 김태헌; 김휘영
- SCOPUS Author ID
- 유권; 김태헌; 김휘영
- Issue Date
- 2021
- Journal Title
- YONSEI MEDICAL JOURNAL
- ISSN
- 0513-5796
1976-2437
- Citation
- YONSEI MEDICAL JOURNAL vol. 62, no. 1, pp. 12 - 20
- Keywords
- Carcinoma; hepatocellular; alpha-fetoprotein; prognosis; treatment outcome; transarterial chemoembolization
- Publisher
- YONSEI UNIV COLL MEDICINE
- Indexed
- SCIE; SCOPUS; KCI
- Document Type
- Article
- Abstract
- 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.
- DOI
- 10.3349/ymj.2021.62.1.12
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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