Clinicopathological and prognostic characteristics in patients with AFP-secreting gastric carcinoma

Abstract

Abstract. The aim of the present study was to determine whether there are any clinicopathological or prognostic differences between patients with α-fetoprotein-secreting gastric carcinoma (AFP-SGC) and non-AFP-SGC. Pathological parameters, clinical parameters, and treatment efficacy were compared in patients with AFP-SGC and non-AFP-SGC. In total, 362 patients (53 with AFP-SGC and 309 with non-AFP-SGC) were included in the present study. Patients with AFP-SGC had significantly higher levels of lymphovascular invasion, perineural invasion (PNI), rate of liver metastasis, and stage IV cancer compared with patients with non-AFP-SGC (P<0.05). The median overall survival (OS) rate was 12.6 months in the AFP-SGC group, and 22.1 months in the non-AFP-SGC group (P<0.001). The median OS and disease free survival (DFS) of patients with stage I-III AFP-SGC were 28.1 and 13.4 months, respectively, whereas for patients with non-AFP-SGC, the OS and DFS were 45.3 and 38.0 months, respectively (P= 0.01; P= 0.02). The median OS for the stage IV AFP-SGC and non-AFP-SGC groups was 9.3 and 11.5 months, respectively (P= 0.14). Multivariate analysis of the entire patient group revealed that the Eastern Cooperative Oncology Group (ECOG) performance score of ≥2, lymph node involvement, presence of PNI, high levels of carcinoembryonic antigen, and distant metastasis were significantly correlated with OS. The lymph node involvement, ECOG performance score of ≥2, AFP-SGC type, and weight loss at diagnosis were also significant factors influencing the DFS in the stage I-III group. In conclusion, patients with AFP-SGC had more aggressive clinicopathological features and biological behavior with an increased tendency of liver metastasis compared with patients with non-AFP-SGC. In the near future, AFP may become an important surrogate marker to manage therapies of patients with gastric cancer.

Efficacy and safety of apatinib for the treatment of AFP-producing gastric cancer

“…In recent years, although several biological or targeted therapies are available for GC, the prognosis of advanced disease is still poor, with a 5-year survival rate that is less than 20%. The median OS of advanced AFPGC was reported to be 9.3 months [19] , which was poorer. The 5year survival rate was 8.3% to 11.9% for all stages of AFPGC [ 20 , 21 ].…”

“…In our study, as a firstor second-line therapy, apatinib got a PFS of 10 months and an OS of 14 months, which were much better than that in the third or more line therapy (3.2, 6.4 months) in the current study (Supplemental Table ). The efficacy of triplet-regimen chemotherapy (Docetaxel, cisplatin, 5fluorouracil; DCF) showed an OS of 9.3 months as the first line in AF-PGC [19] ; however, the AEs of DCF were prominent. Compared with a DCF regimen as first line, the efficacy of apatinib is worth exploring.…”

Prognostic value of serum alpha-fetoprotein levels in patients with gastric cancer: a meta-analysis

“…The literature search identified 340 articles from which 13 articles ultimately met the eligibility criteria (Figure 1). 12,14–25 All 13 studies scored ≥6 (i.e., high-quality study) on the Newcastle–Ottawa Scale. 13 The main features of the 13 studies are summarized in Table 1.…”

Alpha-fetoprotein Promotes the Malignant Phenotype of Hepatocellular Carcinoma Cells: the Drugs Resistance Origination

“…High levels of acetylated AFP showed an association with a poor prognosis in patients with HCC [31] . It has been confirmed in other cancers, such as gastric cancer that secreted AFP significantly increases by lymphovascular infiltration, peripheral nerve infiltration (PNI) compared with gastric cancer without AFP [32] . Colorectal cancers with secreted AFP differ greatly from unsecretory pathological histological features and exhibit higher aggressive behaviors [33] .…”