Association of Postoperative Biomarker Response with Recurrence and Survival in Patients with Hepatocellular Carcinoma and High Alpha-Fetoprotein Expressions (>400 ng/ml)
Lei Liang,1,2,* Ming-Da Wang,3,* Yao-Ming Zhang,4 Wan-Guang Zhang,5 Cheng-Wu Zhang,1 Wan Yee Lau,3,6 Feng Shen,3 Timothy M Pawlik,7 Dong-Sheng Huang,1,2,8 Tian Yang1– 3,8 1Department of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People’s Hospital,...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2021-03-01
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| Series: | Journal of Hepatocellular Carcinoma |
| Subjects: | |
| Online Access: | https://www.dovepress.com/association-of-postoperative-biomarker-response-with-recurrence-and-su-peer-reviewed-article-JHC |
| _version_ | 1819158177234550784 |
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| author | Liang L Wang MD Zhang YM Zhang WG Zhang CW Lau WY Shen F Pawlik TM Huang DS Yang T |
| author_facet | Liang L Wang MD Zhang YM Zhang WG Zhang CW Lau WY Shen F Pawlik TM Huang DS Yang T |
| author_sort | Liang L |
| collection | DOAJ |
| description | Lei Liang,1,2,* Ming-Da Wang,3,* Yao-Ming Zhang,4 Wan-Guang Zhang,5 Cheng-Wu Zhang,1 Wan Yee Lau,3,6 Feng Shen,3 Timothy M Pawlik,7 Dong-Sheng Huang,1,2,8 Tian Yang1– 3,8 1Department of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Zhejiang, People’s Republic of China; 2School of Clinical Medicine, Hangzhou Medical College, Hangzhou, Zhejiang, People’s Republic of China; 3Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), Shanghai, People’s Republic of China; 4The 2nd Department of Hepatobiliary Surgery, Meizhou People’s Hospital, Guangdong, People’s Republic of China; 5Department of Hepatic Surgery, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 6Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China; 7Department of Surgery, Ohio State University, Wexner Medical Center, Columbus, OH, USA; 8The Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Zhejiang Provincial People’ s Hospital (People’ s Hospital of Hangzhou Medical College), Hangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Tian YangDepartment of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, No. 158, Shangtang Road, Hangzhou, Zhejiang, 310014, People’s Republic of ChinaEmail yangtiandfgd@hotmail.comDong-Sheng HuangDepartment of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, No. 158, Shangtang Road, Hangzhou, Zhejiang, 310014, People’s Republic of ChinaEmail Huangdongshengsj@hotmail.comBackground: High alpha-fetoprotein (AFP) expressions (> 400 ng/mL) are associated with poor oncological characteristics for hepatocellular carcinoma (HCC). However, prognosis after liver resection for high-AFP HCC is poorly studied. To investigate long-term recurrence and survival after hepatectomy for high-AFP HCC, and to identify the predictive value of postoperative incomplete biomarker response (IBR) on overall survival (OS) and recurrence-free survival (RFS).Methods: Patients undergoing curative resection for high-AFP HCC were analyzed. According to the decline magnitude of serum AFP as measured at first follow-up (4∼ 6 weeks after surgery), all patients were divided into the complete biomarker response (CBR) and IBR groups. Characteristics, recurrence, and survival rates were compared. Univariate and Multivariate Cox-regression analyses were performed to identify independent predictors associated with poorer OS and RFS after liver resection for high-AFP HCC.Results: Among 549 patients, the overall and early recurrence rates in patients with IBR were significantly higher than patients with CBR (97.8%vs.56.4%, and 92.5%vs.33.3%, both P< 0.001). On multivariate analysis, postoperative IBR was the strongest risk factor with the highest hazard ratio in predicting poor OS (HR 2.97; 95% CI 2.49∼ 3.45; P< 0.001) and RFS (HR 4.29; 95% CI 3.31∼ 5.55; P< 0.001).Conclusion: Postoperative biomarker response of serum AFP can be used in predicting recurrence and survival for high-AFP HCC patients. Once postoperative IBR was identified at first follow-up, subsequent enhanced recurrence surveillance and available treatments against recurrence should actively be considered.Keywords: hepatocellular carcinoma, alpha-fetoprotein, hepatectomy, survival, recurrence |
| first_indexed | 2024-12-22T16:20:31Z |
| format | Article |
| id | doaj.art-713843a72332415592dcfc66eaa119a0 |
| institution | Directory Open Access Journal |
| issn | 2253-5969 |
| language | English |
| last_indexed | 2024-12-22T16:20:31Z |
| publishDate | 2021-03-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Hepatocellular Carcinoma |
| spelling | doaj.art-713843a72332415592dcfc66eaa119a02022-12-21T18:20:15ZengDove Medical PressJournal of Hepatocellular Carcinoma2253-59692021-03-01Volume 810311863042Association of Postoperative Biomarker Response with Recurrence and Survival in Patients with Hepatocellular Carcinoma and High Alpha-Fetoprotein Expressions (>400 ng/ml)Liang LWang MDZhang YMZhang WGZhang CWLau WYShen FPawlik TMHuang DSYang TLei Liang,1,2,* Ming-Da Wang,3,* Yao-Ming Zhang,4 Wan-Guang Zhang,5 Cheng-Wu Zhang,1 Wan Yee Lau,3,6 Feng Shen,3 Timothy M Pawlik,7 Dong-Sheng Huang,1,2,8 Tian Yang1– 3,8 1Department of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Zhejiang, People’s Republic of China; 2School of Clinical Medicine, Hangzhou Medical College, Hangzhou, Zhejiang, People’s Republic of China; 3Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), Shanghai, People’s Republic of China; 4The 2nd Department of Hepatobiliary Surgery, Meizhou People’s Hospital, Guangdong, People’s Republic of China; 5Department of Hepatic Surgery, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 6Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China; 7Department of Surgery, Ohio State University, Wexner Medical Center, Columbus, OH, USA; 8The Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Zhejiang Provincial People’ s Hospital (People’ s Hospital of Hangzhou Medical College), Hangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Tian YangDepartment of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, No. 158, Shangtang Road, Hangzhou, Zhejiang, 310014, People’s Republic of ChinaEmail yangtiandfgd@hotmail.comDong-Sheng HuangDepartment of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, No. 158, Shangtang Road, Hangzhou, Zhejiang, 310014, People’s Republic of ChinaEmail Huangdongshengsj@hotmail.comBackground: High alpha-fetoprotein (AFP) expressions (> 400 ng/mL) are associated with poor oncological characteristics for hepatocellular carcinoma (HCC). However, prognosis after liver resection for high-AFP HCC is poorly studied. To investigate long-term recurrence and survival after hepatectomy for high-AFP HCC, and to identify the predictive value of postoperative incomplete biomarker response (IBR) on overall survival (OS) and recurrence-free survival (RFS).Methods: Patients undergoing curative resection for high-AFP HCC were analyzed. According to the decline magnitude of serum AFP as measured at first follow-up (4∼ 6 weeks after surgery), all patients were divided into the complete biomarker response (CBR) and IBR groups. Characteristics, recurrence, and survival rates were compared. Univariate and Multivariate Cox-regression analyses were performed to identify independent predictors associated with poorer OS and RFS after liver resection for high-AFP HCC.Results: Among 549 patients, the overall and early recurrence rates in patients with IBR were significantly higher than patients with CBR (97.8%vs.56.4%, and 92.5%vs.33.3%, both P< 0.001). On multivariate analysis, postoperative IBR was the strongest risk factor with the highest hazard ratio in predicting poor OS (HR 2.97; 95% CI 2.49∼ 3.45; P< 0.001) and RFS (HR 4.29; 95% CI 3.31∼ 5.55; P< 0.001).Conclusion: Postoperative biomarker response of serum AFP can be used in predicting recurrence and survival for high-AFP HCC patients. Once postoperative IBR was identified at first follow-up, subsequent enhanced recurrence surveillance and available treatments against recurrence should actively be considered.Keywords: hepatocellular carcinoma, alpha-fetoprotein, hepatectomy, survival, recurrencehttps://www.dovepress.com/association-of-postoperative-biomarker-response-with-recurrence-and-su-peer-reviewed-article-JHChepatocellular carcinomaalpha-fetoproteinhepatectomysurvivalrecurrence |
| spellingShingle | Liang L Wang MD Zhang YM Zhang WG Zhang CW Lau WY Shen F Pawlik TM Huang DS Yang T Association of Postoperative Biomarker Response with Recurrence and Survival in Patients with Hepatocellular Carcinoma and High Alpha-Fetoprotein Expressions (>400 ng/ml) Journal of Hepatocellular Carcinoma hepatocellular carcinoma alpha-fetoprotein hepatectomy survival recurrence |
| title | Association of Postoperative Biomarker Response with Recurrence and Survival in Patients with Hepatocellular Carcinoma and High Alpha-Fetoprotein Expressions (>400 ng/ml) |
| title_full | Association of Postoperative Biomarker Response with Recurrence and Survival in Patients with Hepatocellular Carcinoma and High Alpha-Fetoprotein Expressions (>400 ng/ml) |
| title_fullStr | Association of Postoperative Biomarker Response with Recurrence and Survival in Patients with Hepatocellular Carcinoma and High Alpha-Fetoprotein Expressions (>400 ng/ml) |
| title_full_unstemmed | Association of Postoperative Biomarker Response with Recurrence and Survival in Patients with Hepatocellular Carcinoma and High Alpha-Fetoprotein Expressions (>400 ng/ml) |
| title_short | Association of Postoperative Biomarker Response with Recurrence and Survival in Patients with Hepatocellular Carcinoma and High Alpha-Fetoprotein Expressions (>400 ng/ml) |
| title_sort | association of postoperative biomarker response with recurrence and survival in patients with hepatocellular carcinoma and high alpha fetoprotein expressions gt 400 ng ml |
| topic | hepatocellular carcinoma alpha-fetoprotein hepatectomy survival recurrence |
| url | https://www.dovepress.com/association-of-postoperative-biomarker-response-with-recurrence-and-su-peer-reviewed-article-JHC |
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