Alpha-fetoprotein-L3: Useful or Useless for Hepatocellular Carcinoma?

doi:10.1159/000343847

Cited by 22 publications

(20 citation statements)

References 6 publications

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“…The latter guideline recommends the following in relation to surveillance: super high-risk patients (with hepatitis B/C cirrhosis) should be screened by performing ultrasound (US) examinations and measuring the levels of 3 tumor markers (AFP, AFP L-3, and PIVKA-II) every 3-4 months and by performing dynamic CT/MRI every 6-12 months. High-risk patients (with chronic hepatitis B/C or cirrhosis of another origin) should be screened by performing US examinations and measuring the levels of the 3 tumor markers every 6 months [3,4,5,6]. …”

Section: Introductionmentioning

confidence: 99%

Surveillance and Diagnostic Algorithm for Hepatocellular Carcinoma Proposed by the Liver Cancer Study Group of Japan: 2014 Update

et al. 2014

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Surveillance and diagnostic algorithms for hepatocellular carcinoma (HCC) have already been described in guidelines published by the American Association for the Study of Liver Diseases (AASLD), the European Association for the Study of the Liver and the European Organisation for Research and Treatment of Cancer (EASL-EORTC), and the Japan Society of Hepatology (JSH), but the content of these algorithms differs slightly. The JSH algorithm mainly differs from the other two algorithms in that it is highly sophisticated and considers the functional imaging techniques of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced MRI (EOB-MRI) and Sonazoid contrast-enhanced ultrasound (CEUS) to be very important diagnostic modalities. In contrast, the AASLD and EASL-EORTC algorithms are less advanced and suggest that a diagnosis be made based solely on hemodynamic findings using dynamic CT/MRI and biopsy findings. A consensus meeting regarding the JSH surveillance and diagnostic algorithm was held at the 50th Liver Cancer Study Group of Japan Congress, and a 2014 update of the algorithm was completed. The new algorithm reaffirms the very important role of EOB-MRI and Sonazoid CEUS in the surveillance and diagnosis of liver cancer and is more sophisticated than those currently used in the United States and Europe. This is now an optimized algorithm that can be used to diagnose early-stage to classical HCC easily and highly accurately.

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Section: Introductionmentioning

confidence: 99%

Surveillance and Diagnostic Algorithm for Hepatocellular Carcinoma Proposed by the Liver Cancer Study Group of Japan: 2014 Update

et al. 2014

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“…In a previous study, we reported that the duration of administration was a significant prognostic factor for sorafenib treatment. A blood chemical test related to liver functions, such as serum levels of bilirubin as well as the tumor markers alpha-fetoprotein (AFP) and des-gamma carboxyprothrombin (DCP), could also be a marker predicting an overall survival (OS) [31,32,33,34]. In the current study, we retrospectively investigated 356 HCC patients treated with sorafenib at the Kinki University Hospital to elucidate the efficacy of sorafenib treatment and the clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

Real-Life Clinical Practice with Sorafenib in Advanced Hepatocellular Carcinoma: A Single-Center Experience Second Analysis

Arizumi

Ueshima

Iwanishi

et al. 2015

Dig Dis

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Objectives: Sorafenib has become a standard therapy for advanced hepatocellular carcinoma following the demonstration of significant increase in progression-free survival as well as overall survival (OS) in the 2-phase III trials. We examined efficacy and adverse events (AEs) in patients treated with sorafenib over a 6-year period since approval in Japan. Methods: Two hundred and forty-one patients treated with sorafenib at the Kinki University Hospital were retrospectively analyzed clinically for the factors related to survival periods, tumor response evaluated by the Response Evaluation Criteria In Cancer of the Liver (RECICL) and AEs. Results: OS was 14.3 months. According to the RECICL, the objective response and disease control rates were 18.6% (43 of 241) and 61.1% (137 of 241), respectively. AEs were seen in 77.3% (187 of 241), with Grade 3 or higher in 23.6% (57 of 241). The most frequent AE was hand-foot skin reaction in 109 patients (45.0%), and 28 patients (11.8%) showed Grade 3 or higher. Significant factors contributing to the OS were treatment duration (p = 0.0204), up-to-7 criteria (p = 0.0400), increase of Child-Pugh score (p = 0.0008) and tumor response determined by the RECICL (p = 0.0007). Conclusion: Based on the analysis, using many cases at a single center, we concluded that continuation of treatment with sorafenib for ≥90 days without decrease of liver function was critical if tumor response was determined as stable disease or higher.

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“…On the other hand, AFP-L3 and DCP are well known to have an influence of malignancy grading. AFP-L3 production is largely related to the degree of biological malignancy of HCC [16,22]. Moreover, a high level (>100 mAU/ml) of DCP is a risk factor for microvascular invasion [23].…”

Section: Discussionmentioning

confidence: 99%

“…The biomarker-combined JIS (bm-JIS) score [5] includes three tumor markers [15], alpha-fetoprotein (AFP), Lens culinaris agglutinin-reactive alpha-fetoprotein (AFP-L3) fraction [16] and des-gamma-carboxyprothrombin (DCP), specific for HCC. It has been shown to offer better stratification ability and prognostic predictive power than the c-JIS score, the Cancer of the Liver Italian Program (CLIP) score [6] and the BALAD score [17].…”

Section: Introductionmentioning

confidence: 99%

Validation of Three Staging Systems for Hepatocellular Carcinoma (JIS Score, Biomarker-Combined JIS Score and BCLC System) in 4,649 Cases from a Japanese Nationwide Survey

Kitai

Kudo

Izumi

et al. 2014

Dig Dis

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Objective: Clinical staging is very important for optimal therapeutic strategy and prognostic prediction in patients with hepatocellular carcinoma (HCC). The Barcelona Clinic Liver Cancer (BCLC) staging system is the most widely used and best-validated method for HCC. Similarly, the conventional Japan Integrated Staging (c-JIS) score and the biomarker-combined JIS (bm-JIS) score have also been reported to effectively stratify HCC patients. The aim of this study was to evaluate the performance of these three staging systems for prognostic prediction. Methods: A total of 4,649 HCC patients were included in this study. A multivariate analysis identified the independent risk factors associated with overall survival. The stratification ability and the suitability as a prognostic model of the three staging systems were compared. Results: Multivariate analysis revealed that male sex, higher Child-Pugh score, tumor size >2.0 cm, multiple tumors, vascular invasion, higher alpha-fetoprotein (AFP) level, higher des-gamma-carboxyprothrombin level, higher Lens culinaris agglutinin-reactive AFP level, and a performance status of 3-4 were independent risk factors in HCC. The independent homogenizing ability and stratification value of the bm-JIS score were higher than those of the c-JIS score and the BCLC system (χ² = 972.7581, 758.1041 and 679.6832, respectively). Moreover, the bm-JIS score had the lowest Akaike Information Criteria value, followed by the c-JIS score and the BCLC system (9,844.278, 10,054.93 and 10,131.35, respectively). Conclusions: Our results suggest that the bm-JIS score offers good stratification ability and is a better prognostic predictor than the c-JIS score and the BCLC system.

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Alpha-fetoprotein-L3: Useful or Useless for Hepatocellular Carcinoma?

Cited by 22 publications

References 6 publications

Surveillance and Diagnostic Algorithm for Hepatocellular Carcinoma Proposed by the Liver Cancer Study Group of Japan: 2014 Update

Surveillance and Diagnostic Algorithm for Hepatocellular Carcinoma Proposed by the Liver Cancer Study Group of Japan: 2014 Update

Real-Life Clinical Practice with Sorafenib in Advanced Hepatocellular Carcinoma: A Single-Center Experience Second Analysis

Validation of Three Staging Systems for Hepatocellular Carcinoma (JIS Score, Biomarker-Combined JIS Score and BCLC System) in 4,649 Cases from a Japanese Nationwide Survey

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