Email updates

Keep up to date with the latest news and content from BMC Cancer and BioMed Central.

Open Access Research article

Prognostic value of α-fetoprotein and des-γ-carboxy prothrombin responses in patients with hepatocellular carcinoma treated with transarterial chemoembolization

Yong Kang Lee1, Seung Up Kim134, Do Young Kim134, Sang Hoon Ahn1345, Kwang Hun Lee234, Do Yun Lee234, Kwang-Hyub Han1345, Chae Yoon Chon134 and Jun Yong Park134*

  • * Corresponding author: Jun Yong Park DRPJY@yuhs.ac

  • † Equal contributors

Author affiliations

1 Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun–gu, Seoul 120-752, Korea

2 Department of Radiology, Yonsei University College of Medicine, Seoul, Korea

3 Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea

4 Liver Cirrhosis Clinical Research Center, Seoul, Korea

5 Brain Korea 21 Project for Medical Science, Seoul, Korea

For all author emails, please log on.

Citation and License

BMC Cancer 2013, 13:5  doi:10.1186/1471-2407-13-5

Published: 3 January 2013

Abstract

Background/Aims

Alpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) have been used as diagnostic tools for hepatocellular carcinoma (HCC). However, prediction of outcome using AFP and DCP has not been elucidated. We investigated the clinical role of AFP and DCP as predictors of treatment outcome in patients with HCC undergoing trans-arterial chemoembolization (TACE).

Methods

Between January 2003 and December 2005, we enrolled 115 treatment-naïve patients who received TACE as an initial treatment modality. An AFP or DCP response was defined as a reduction of more than 50% from the baseline level 1 month after TACE. Patients with AFP < 20 ng/mL or DCP < 20 mAU/mL were excluded.

Results

The median age was 59 years and the male gender predominated (n = 81, 70.4%). AFP and DCP response was identified in 91 (79.1%) and 77 (66.9%) patients after TACE. Although progression-free survival (PFS) did not differ according to AFP response (P = 0.150), AFP responders showed significantly better overall survival (OS) than non-responders (34.9 vs. 13.2 months; P = 0.002). In contrast, DCP response did not influence either PFS or OS (all P > 0.05). Multivariate analyses showed that gamma-glutamyltranspeptidase and baseline AFP were predictors of PFS (all P < 0.05) and that male gender, the presence of liver cirrhosis, baseline DCP, number of measurable tumors and AFP response were independent predictors of OS (all P < 0.05).

Conclusions

AFP response and higher baseline DCP level are significant predictors of OS in treatment-naïve patients with HCC receiving TACE who showed pretreatment elevation of both AFP and DCP.

Keywords:
Alpha-fetoprotein; Des gamma carboxy prothrombin; Transarterial chemoembolization; Tumor marker response; Hepatocellular carcinoma; Prognosis; Survival