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. 2014 Jul 4:14:40.
doi: 10.1186/1471-2482-14-40.

Effect of pre- and post-treatment α-fetoprotein levels and tumor size on survival of patients with hepatocellular carcinoma treated by resection, transarterial chemoembolization or radiofrequency ablation: a retrospective study

Adriana Toro, Annalisa Ardiri, Maurizio Mannino, Maria Concetta Arcerito, Giovanni Mannino, Filippo Palermo, Gaetano Bertino, Isidoro Di Carlo  1
Affiliations

Effect of pre- and post-treatment α-fetoprotein levels and tumor size on survival of patients with hepatocellular carcinoma treated by resection, transarterial chemoembolization or radiofrequency ablation: a retrospective study

Adriana Toro et al. BMC Surg. .

Abstract

Background: We evaluated treatment modalities and survival in patients with hepatocellular carcinoma (HCC), by pre-treatment and 3-month post-treatment serum alpha-fetoprotein (AFP) levels and pre-treatment tumor diameters.

Methods: We retrospectively reviewed 57 patients treated for HCC in our department from January 2002 to December 2012, including their sex, type of hepatitis, Child class, pre-treatment tumor size, pre-treatment levels of albumin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), red blood cells, hemoglobin, and total bilirubin, pre- and 3-month post-treatment serum AFP, and treatment modality (transarterial chemoembolization, resection or radiofrequency ablation). Survival was analyzed at 1, 3, and 5 years after treatment.

Results: The 57 patients included 44 men and 13 women, of whom 44 had hepatitis C virus (HCV) infection, 3 had hepatitis B virus (HBV) infection, 3 had both HBV and HCV infection, 1 had both HBV and hepatitis D virus infection, and 3 had alcohol-related liver cirrhosis. Both pre- and post-treatment serum AFP levels significantly correlated with recurrent tumor size (P < 0.05 for both). Pre-treatment tumor size did not correlate with recurrent tumor size. Patients who underwent hepatic resection survived significantly longer than those who underwent transarterial chemoembolization or radiofrequency ablation (P < 0.05).

Conclusions: Serum AFP level is useful in diagnosing tumor recurrence and predicting prognosis in HCC patients treated by hepatic resection, transarterial chemoembolization, and radiofrequency ablation. Hepatic resection remains the treatment of choice for HCC in suitable patients.

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Figures

Figure 1
Figure 1
Survival of all patients after hepatic resection, transarterial chemoembolization, and radiofrequency ablation.
Figure 2
Figure 2
Correlations between studied variables and recurrent tumor size in all patients. (a) Pre-treatment serum AFP level (AFPT0) and recurrent tumor size (RTS) were significantly correlated (r = 0.329 P < 0.05). (b) Recurrent tumor size (TST0) and RTS were not correlated (r = 0.020, P > 0.05). (c) The 3-month post-treatment serum level (AFTT3) and recurrent tumor size were significantly correlated (r = 0.312, P < 0.05).
Figure 3
Figure 3
Correlations between studied variables and recurrent tumor size in patients who underwent HR. (a) Pre-treatment serum AFP level (AFPT0) and recurrent tumor size (RTS) were not correlated (r = 0.206, P > 0.05). (b) Recurrent tumor size (TST0) and RTS were not correlated (r = 0.101, P > 0.05). (c) The 3-month post-treatment serum level (AFTT3) and RTS were not correlated (r = 0.251, P > 0.05).
Figure 4
Figure 4
Correlations between studied variables and recurrent tumor size in patients who underwent TACE. (a) Pre-treatment serum AFP level (AFPT0) and recurrent tumor size (RTS) were not correlated (r = 0.371, P > 0.05). (b) Recurrent tumor size (TST0) and RTS were not correlated (r = 0.190, P > 0.05). (c) The 3-month post-treatment serum level (AFTT3) and RTS were not correlated (r = 0.273, P > 0.05).
Figure 5
Figure 5
Correlations between studied variables and recurrent tumor size in patients who underwent RFA. (a) Pre-treatment serum AFP level (AFPT0) and recurrent tumor size (RTS) were not correlated (r = 0.042, P > 0.05). (b) Recurrent tumor size (TST0) and RTS were not correlated (r = 0.020, P > 0.05). (c) The 3-month post-treatment serum level (AFTT3) and RTS were not correlated (r = 0.396, P > 0.05).
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