Relationship between serum alpha-foetoprotein, cirrhosis and survival in hepatocellular carcinoma

Abstract

Summary.-An analysis of survival time of 57 West European patients with hepatocellular carcinoma was carried out to define which of several possible factors (age, sex, cirrhosis and raised serum a-foetoprotein (AFP)) influenced survival. Although survival was significantly longer in younger patients (P<0-02) and in patients with normal serum AFP (P< 001), multivariate analysis showed that significant variation in survival time is better explained by the single factor, the presence of cirrhosis, than by AFP level. This does not seem to apply for patients with this tumour in Africa and the Far East, and there may be a fundamental difference in the natural history of the tumour between high-and low-incidence areas.

Unique clinical characteristics of patients with hepatocellular carcinoma who present with high plasma des-?-carboxy prothrombin and low serum ?-fetoprotein

“…Those with high serum AFP levels at the time of HCC diagnosis result in unfavorable outcomes compared with the outcomes of patients who have low AFP levels. 9,10 Similar results were also reported for DCP. 11 When both tumor markers are measured in HCC patients, those with elevated values of both AFP and DCP have the lowest survival rates.…”

Hepatocellular Carcinoma in Cirrhotic and Noncirrhotic Livers:A Clinico-Histopathologic Study of 804 North American Patients

“…This confirms reports from the United States 10 and other pans of the world 43 that had similar findings, and that idmtiikd cirrhosis as the major independent risk factor advei si'iy affecting survival of patients with HCC. 43 The fibrolamellar variant of HCC ported to occur at younger ages, ai prognosis than nonfibrolamellar type thus might be expected to influcne survival data in a study such as llii of cases seen at the AFIP since i : ' there is indeed a significantly b FLC compared with non-FL( shows further, that non-cirrhotii has been reave a better FLC), 21 and graphic and . Oi:.…”

Tumor and liver determinants of prognosis in unresectable hepatocellular carcinoma: a large case cohort study

“…Using a similar strategy and the same logic, we also suggest that the presence of AFP above the normal level for our lab, is a similar negative prognostic indicator of survival in each of the patient subgroups, when defined by liver function and tumor extension, as previously described [30,31]. Thus, a similar inference can be made, namely that AFP positive and AFP negative HCC represent discrete phenotypes, with different rates of tumor progression.…”