Prognostic role of serial alpha-fetoprotein levels in hepatocellular carcinoma treated with locoregional therapy

Paul, Shashi Bala ; Sahu, Pabitra ; Sreenivas, Vishnubhatla ; Nadda, Neeti ; Gamanagatti, Shivanand R. ; Nayak, Baibaswata ; Shalimar, S. ; Acharya, Subrat K. (2019) Prognostic role of serial alpha-fetoprotein levels in hepatocellular carcinoma treated with locoregional therapy Scandinavian Journal of Gastroenterology, 54 (9). pp. 1132-1137. ISSN 0036-5521

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Background and aim: To evaluate early serial AFP changes in responders and non-responders to locoregional therapy and identify differences between significant AFP decliners and non-decliners post-treatment. Methods: Case records of hepatocellular carcinoma (HCC) patients having AFP ≥20 ng/ml and treated with locoregional therapy were examined retrospectively. Patients with complete details were included. Trends of serial AFP change (from baseline to post-treatment one month) in patients showing early tumor response (complete response (CR), partial response (PR), progressive disease (PD)) as assessed on multiphasic MRI/CT liver performed at one month following treatment. Receiver operating curves were drawn to estimate the best AFP reduction cut off for differentiating between responders (CR plus PR) from non-responders (PD). AFP decliners (those with AFP level reduction greater than 20% post-treatment) were identified and comparisons of their clinical parameters, tumor response and survival rate were made with AFP non-decliners. Results: HCC patients (n = 126) had mean age of 52.8 years, male:female ratio (4:1), Child's A 94, BCLC stage A/B/C HCC 49/65/12, respectively. On 4-6 weeks' MRI/CT, 46 patients developed CR, 55 PR and 25 PD. Reduction in median AFP level (83% in CR, 19% in PR) occurred in responders while 16% increase occurred in PD patients (non-responders). A 30% AFP reduction could differentiate responders from non-responders with 70% sensitivity and 68% specificity, AUROC 74% (CI 0.64-0.85). AFP decliners showed better survival and tumor response than non-decliners. Conclusions: Serial AFP change can predict tumor response to locoregional therapy in AFP producing HCC patients. AFP decliners have better survival and tumor response than AFP non-decliners.

Item Type:Article
Source:Copyright of this article belongs to Taylor & Francis Group
Keywords:Hepatocellular carcinoma; alpha-fetoprotein; locoregional therapy; survival; tumor response
ID Code:128815
Deposited On:21 Nov 2022 11:49
Last Modified:21 Nov 2022 11:49

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