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. 2013 Sep 28;19(36):6055-61.
doi: 10.3748/wjg.v19.i36.6055.

Liver metastasis is the only independent prognostic factor in AFP-producing gastric cancer

Shoji Hirajima  1 , Shuhei Komatsu, Daisuke Ichikawa, Takeshi Kubota, Kazuma Okamoto, Atsushi Shiozaki, Hitoshi Fujiwara, Hirotaka Konishi, Hisashi Ikoma, Eigo Otsuji
Affiliations

Liver metastasis is the only independent prognostic factor in AFP-producing gastric cancer

Shoji Hirajima et al. World J Gastroenterol. .

Abstract

Aim: To investigate differences between common gastric cancer and α-fetoprotein (AFP)-producing gastric cancer according to the presence or absence of liver metastasis.

Methods: Between 1997 and 2011, 1299 patients underwent gastrectomy for gastric cancer (GC) at our institute and their hospital records were reviewed retrospectively. Patients were immunohistochemically divided into two groups: 23 patients (1.8%) with AFP-producing GC and 1276 patients (98.2%) without it.

Results: AFP-producing GC patients had a significantly higher incidence of deeper tumors, venous invasion, lymphatic invasion, lymph node metastasis, and liver metastasis and a poorer prognosis (P < 0.005) than those without AFP-producing GC. However, multivariate analysis revealed that AFP-positivity was not an independent prognostic factor. The prognosis of AFP-producing GC was similar to that of AFP-non producing GC according to the presence or absence of liver metastasis. Concerning recurrence, 47.8% of patients (11/23) with AFP-producing GC and 20.0% of patients (256/1276) without AFP-producing GC exhibited recurrence. Liver metastasis [90.9% (10/11)] was the most prevalent in AFP-producing GC patients. Multivariate analysis revealed that liver metastasis was the only independent prognostic factor in AFP-producing GC (HR = 17.6, 95%CI: 2.1-147.1; P = 0.0081).

Conclusion: AFP-producing GC is similar to common GC without liver metastasis, which should be specifically targeted in an effort to improve the prognosis of AFP-producing GC patients.

Keywords: Gastric cancer; Immunostaining; Liver metastasis; Poor prognosis; α-fetoprotein.

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Figures

Figure 1
Figure 1
Survival curves between α-fetoprotein-producing gastric cancer and α-fetoprotein-non producing gastric cancer. The postoperative cause-specific 5-year survival rate of patients with α-fetoprotein (AFP)-producing gastric cancer (GC) was significantly poorer than that of patients without AFP-producing GC (5-year survival rate: 50.3% and 76.5%, P = 0.002).
Figure 2
Figure 2
Survival curves between patients with and without α-fetoprotein-producing gastric cancer according to the presence (A) or absence (B) of liver metastasis. The prognosis of α-fetoprotein (AFP)-producing gastric cancer (GC) was similar to that of AFP-non producing GC according to the presence (A, P = 0.3778) or absence (B, P = 0.5024) of liver metastasis.
See this image and copyright information in PMC

References

    1. Bergstrand CG, Czar B. Demonstration of a new protein fraction in serum from the human fetus. Scand J Clin Lab Invest. 1956;8:174. - PubMed
    1. Nishimura H, Okamoto Y, Takahashi M, Fujita T. Occurrence of alpha-fetoprotein, Regan isoenzyme, and variant alkaline phosphatase in the serum of a patient with gastric cancer. Gastroenterology. 1976;71:497–499. - PubMed
    1. Masuzawa M, Lee PK, Kamada T, Akeyama T, Abe H, Shimano T, Mori T, Morino H, Ishiguro S. Carcinoembryonic antigen, alpha-fetoprotein and carcinoplacental alkaline phosphatase in gastric carcinoma metastatic to the liver. Cancer. 1977;39:1175–1180. - PubMed
    1. Kodama T, Kameya T, Hirota T, Shimosato Y, Ohkura H, Mukojima T, Kitaoka H. Production of alpha-fetoprotein, normal serum proteins, and human chorionic gonadotropin in stomach cancer: histologic and immunohistochemical analyses of 35 cases. Cancer. 1981;48:1647–1655. - PubMed
    1. Ooi A, Okada Y, Minamoto T, Imabori T, Shima K. [A case of alpha-fetoprotein-producing gastric carcinoma with histologic features of embryonal carcinoma] Gan No Rinsho. 1985;31:334–340. - PubMed

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