Preoperative tumor marker doubling time is a useful predictor of recurrence and prognosis after hepatic resection of hepatocellular carcinoma
✍ Scribed by Toshiro Masuda; Toru Beppu; Kei Horino; Hiroyuki Komori; Hiromitsu Hayashi; Hirohisa Okabe; Ryu Otao; Hasita Horlad; Takatoshi Ishiko; Hiroshi Takamori; Ken Kikuchi; Hideo Baba
- Publisher
- John Wiley and Sons
- Year
- 2009
- Tongue
- English
- Weight
- 223 KB
- Volume
- 102
- Category
- Article
- ISSN
- 0022-4790
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✦ Synopsis
Abstract
Background and Objectives
It is important to identify prognostic factors in patients with hepatocellular carcinoma (HCC) before hepatectomy. No previous studies have addressed the predictive efficacy of the preoperative doubling times of alpha‐fetoprotein (AFP) and protein induced by vitamin K absence (PIVKA‐II).
Methods
A total of 210 HCC patients who underwent a hepatic resection between 1998 and 2006 were prospectively evaluated. Serum AFP and PIVKA‐II levels were measured at least twice before surgery to calculate the doubling times. Nineteen clinical factors that can be examined preoperatively, including the doubling times of AFP and PIVKA‐II were investigated to identify prognostic factors for disease‐free and overall survival after hepatectomy.
Results
There was no relationship between preoperative levels and doubling times of AFP and PIVKA‐II. In a multivariate analysis, patients with a doubling time of AFP ≤30 days and PIVKA‐II ≤16 days showed a significantly worse disease‐free (P = 0.02, P = 0.03, respectively) and overall survival (P < 0.0001, P = 0.03, respectively).
Conclusions
In HCC patients, the doubling times of preoperative serum AFP or PIVKA‐II levels are useful tools to predict early postoperative recurrence and a poor prognosis. J. Surg. Oncol. 2010;102:490–496. © 2009 Wiley‐Liss, Inc.