Prognostic role of alpha-fetoprotein in patients with hepatocellular carcinoma treated with repeat transarterial chemoembolisation

Mishra, Gauri; Dev, Anouk; Paul, Eldho; Cheung, Wa; Koukounaras, Jim; Jhamb, Ashu; Marginson, Ben; Lim, Beng Ghee; Simkin, Paul; Borsaru, Adina; Burnes, James; Goodwin, Mark; Ramachandra, Vivek; Spanger, Manfred; Lubel, John S; Gow, Paul J; Sood, Siddharth; Thompson, Alexander; Nicoll, Amanda; Bell, Sally; Majeed, Ammar; Kemp, William; Roberts, Stuart K.

doi:10.1186/s12885-020-06806-4

Cited by 7 publications

(5 citation statements)

References 75 publications

(108 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…After PSM, multivariate analysis in the Ki67 low expression group showed that a preoperative AFP level >200mg/liter (13) and a tumor maximum diameter ≥5 cm (14) were independent risk factors for RFS and OS rates in patients post-operatively, and liver cirrhosis was an independent risk factor for RFS (HR = 3.50 and 2.58, P = 0.001 and 0.015, respectively; and HR = 4.10 and 2.79, P = 0.006 and 0.041, respectively; and HR = 2.39, P = 0.02).…”

Section: Multivariate Analysis On Recurrence and Survival Of Patientsmentioning

confidence: 99%

Evaluation of the Therapeutic Effect of Adjuvant Transcatheter Arterial Chemoembolization Based on Ki67 After Hepatocellular Carcinoma Surgery

et al. 2021

View full text Add to dashboard Cite

Background and aimsThis study aimed to determine the relationship between Ki67 expression and the efficacy of postoperative adjuvant transcatheter arterial chemoembolization (PA-TACE) in patients with hepatocellular carcinoma.MethodsThe Kaplan-Meier method was used to analyze the recurrence-free survival (RFS) and overall survival (OS) rates between the sub-groups in the ki67 low expression group and the ki67 high expression group and analyze the relationship between the expression of Ki67 and the efficacy of TACE.ResultsAfter PSM, there was no significant difference in the RFS and OS between the surgery + TACE and surgery subgroups after 1, 2, or 3 years (RFS: 63.9%, 55.6%, and 42.9% vs. 83.3%, 63.9%, and 55.6%, respectively, P = 0.279; OS: 91.7%, 83.3%, and 74.3% vs. 91.7%, 88.9%, and 71.4%, respectively, P = 0.890) in the Ki67 low-expression group. The RFS and OS were higher in the surgery + TACE subgroup than the surgery subgroup after 1, 2, and 3 years (RFS: 80.0%, 77.5%, and 69.2% vs. 53.5%, 39.5%, and 32.6%, respectively, P<0.001; OS: 97.5%, 85.0%, and 79.5% vs. 79.1%, 48.8%, and 42.9%, respectively, P = 0.001) in the Ki67 high expression group. The RFS was higher in the Ki67 high-expression subgroup than the low-expression subgroup after 1, 2, and 3 years, and OS had no significant difference (RFS: 80.0%, 79.5%, and 69.2% vs. 67.4%, 56.5%, and 46.7%, respectively, P = 0.035; OS: 97.5%, 85.0%, and 79.5% vs. 93.5%, 82.6%, and 75.6%, respectively, P = 0.665) in the surgery + TACE group.ConclusionsFor patients with hepatocellular carcinoma and high expression of Ki67 (Ki67≥20%), adjuvant hepatic artery chemoembolization after radical liver tumor resection effectively reduced the probability of tumor recurrence after surgery and prolonged the OS of patients. High Ki67 expression during the post-operative follow-up evaluation of hepatocellular carcinoma patients is an indicator for adjuvant TACE therapy.

show abstract

Section: Multivariate Analysis On Recurrence and Survival Of Patientsmentioning

confidence: 99%

Evaluation of the Therapeutic Effect of Adjuvant Transcatheter Arterial Chemoembolization Based on Ki67 After Hepatocellular Carcinoma Surgery

et al. 2021

View full text Add to dashboard Cite

show abstract

“…TACE is an effective treatment in patients with unresectable HCC, however most patients treated with TACE will need repeat therapy due to partial response or tumor recurrence. Treatment outcomes after TACE depend on both the severity of underlying liver dysfunction and tumor burden (34). In our study, pre-transplant PIVKA-II levels correlated with the number of TACEs performed prior to pre-transplant sampling.…”

Section: Discussionmentioning

confidence: 54%

Usefulness of PIVKA-II for Monitoring After Liver Transplantation in Patients With Hepatocellular Carcinoma

LÓPEZ

Mateos

LORENCIO

et al. 2022

Preprint

View full text Add to dashboard Cite

The high morbidity and mortality of hepatocellular carcinoma (HCC) has encouraged the search for new biomarkers to be used alongside alpha-foetoprotein (AFP) and imaging tests. The aim of this study was to evaluate the clinical contribution of protein induced by vitamin K absence or antagonist-II (PIVKA-II) for HCC monitoring after liver transplantation (LT) and compare it with AFP, a routinely used tumour marker. A total of 46 HCC patients (Milan criteria) were enrolled in this study. Serum levels of PIVKA-II and AFP were measured before and after transplantation. Clinical features were determined for all the patients that were included. Significant correlations were found between PIVKA-II expression levels and some clinicopathological features, such as tumour size and number of pre-transplant transarterial chemoembolizations (TACEs). Serum levels of PIVKA-II and AFP decreased significantly after LT and increased in patients with tumour recurrence. Serum PIVKA-II levels may play an important role in predicting disease severity. Furthermore, monitoring PIVKA-II levels in HCC transplant recipients reflects the tumor early recurrence after transplantation and could be used, complementing AFP and imaging tests, as a novel biomarker of this pathology.

show abstract

“…Data regarding the significant role of the dynamic changes of AFP following TACE were published previously not only in liver transplant patients but also in those where LRT was applied as a first-line treatment. In their study, Mishra et al showed that patients with AFP < 200 ng/mL before and after the first TACE had a better prognosis compared with those with an initial AFP ≥ 200 ng/mL or progressing beyond this threshold after the first procedure (p = 0.0001, [29]). Similarly, other authors have also revealed a positive correlation between AFP response and better long-term results.…”

Section: Discussionmentioning

confidence: 98%

Alpha-Fetoprotein Response after First Transarterial Chemoembolization (TACE) and Complete Pathologic Response in Patients with Hepatocellular Cancer

Masior,

Krasnodębski,

Kuncewicz

et al. 2023

Cancers

View full text Add to dashboard Cite

Transarterial chemoembolization (TACE) is used as a bridging treatment in liver transplant candidates with hepatocellular carcinoma (HCC). Alpha-fetoprotein (AFP) is the main tumor marker used for HCC surveillance. The aim of this study was to assess the potential of using the AFP change after the first TACE in the prediction of complete tumor necrosis. The study comprised 101 patients with HCC who underwent liver transplantation (LT) after TACE in the period between January 2011 and December 2020. The ΔAFP was defined as the difference between the AFP value before the first TACE and AFP either before the second TACE or the LT. The receiver operator characteristics (ROC) curves were used to identify an optimal cut-off value. Complete tumor necrosis was found in 26.1% (18 of 69) and 6.3% (2 of 32) of patients with an initial AFP level under and over 100 ng/mL, respectively (p = 0.020). The optimal cut-off value of ΔAFP for the prediction of complete necrosis was a decline of ≥10.2 ng/mL and ≥340.5 ng/mL in the corresponding subgroups. Complete tumor necrosis rates were: 62.5% (5 of 8) in patients with an initial AFP < 100 ng/mL and decline of ≥10.2 ng/mL; 21.3% (13 of 61) in patients with an initial AFP < 100 ng/mL and decline of <10.2 ng/mL; 16.7% (2 of 12) in patients with an initial AFP > 100 ng/mL and decline of ≥340.5 ng/mL; and null in 20 patients with an initial AFP > 100 ng/mL and decline of <340.5 ng/mL, respectively (p = 0.003). The simple scoring system, based on the initial AFP and AFP decline after the first treatment, distinguished between a high, intermediate and low probability of complete necrosis, with an area under the ROC curve of 0.699 (95% confidence intervals 0.577 to 0.821, p = 0.001). Combining the initial AFP with its change after the first treatment enables early identification of the efficacy of TACE.

show abstract

Prognostic role of alpha-fetoprotein in patients with hepatocellular carcinoma treated with repeat transarterial chemoembolisation

Cited by 7 publications

References 75 publications

Evaluation of the Therapeutic Effect of Adjuvant Transcatheter Arterial Chemoembolization Based on Ki67 After Hepatocellular Carcinoma Surgery

Evaluation of the Therapeutic Effect of Adjuvant Transcatheter Arterial Chemoembolization Based on Ki67 After Hepatocellular Carcinoma Surgery

Usefulness of PIVKA-II for Monitoring After Liver Transplantation in Patients With Hepatocellular Carcinoma

Alpha-Fetoprotein Response after First Transarterial Chemoembolization (TACE) and Complete Pathologic Response in Patients with Hepatocellular Cancer

Contact Info

Product

Resources

About