Background:
The recurrence of hepatocellular carcinoma (hcc) after surgery is common. the present study was conducted in order to clarify the significance of alpha-fetoprotein (afp) in the detection of the early recurrence of hcc after surgery.
Methods:
Fifty-eight patients who underwent a curative hepatic resection for hcc and whose preoperative afp levels were >100 ng/ml, were selected for this study.
Results:
In 26 cases, the postoperative afp levels within 3 months after surgery did not decrease to <20 ng/ml (high afp group). in the other 32 cases, the postoperative afp levels within 3 months after surgery decreased to <20 ng/ml (low afp group). no significant difference was observed in clinical or pathological backgrounds. the postoperative disease free rate in the low and high afp groups was 84.2% and 18.4%, at 1 year, 61.2 and 4.6% at 3 years, respectively. the difference was statistically significant (p < 0.01). at the time of recurrence, the afp levels increased in 25 (96.2%) of the patients who had early recurrence within 1 year after surgery as well as in 11 of 14 (78.5%) who had recurrence >1 year after surgery. the interval from surgery to recurrence significantly correlated with the doubling time of afp at the time of recurrence in patients with early recurrence (within 1 year after hepatectomy) (r = 0.60, p < 0.01). in cases in which the preoperative afp level was >100 ng/ml and the postoperative afp level did not decrease to <20 ng/ml, early recurrence within 1 year after surgery would thus be strongly suspected.
Conclusion:
The measurement of the afp levels after surgery is therefore considered to be important in the follow-up of hepatectomized patients, especially regarding the detection of early recurrence.