Alpha-fetoprotein response following transarterial chemoembolization indicates improved survival for intermediate-stage hepatocellular carcinoma |
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Authors: | Guanghua Liu Qiang Ouyang Fang Xia Guoping Fan Juming Yu Caiyuan Zhang Dengbin Wang |
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Affiliation: | 1. Department of Radiology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China;2. Department of Interventional Radiology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China;3. Department of Hepatic Surgery, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China;4. Department of Cardiology, Dahua Hospital, Xuhui District, Shanghai 200237, China |
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Abstract: | BackgroundTo investigate the clinical value of the alpha-fetoprotein (AFP) response following transcatheter arterial chemoembolization (TACE) in intermediate-stage hepatocellular carcinoma (HCC).MethodsData on patients with Barcelona Clinic Liver Cancer B staging system were analyzed. An AFP response was defined as a decrease in AFP of more than 20% after a TACE session. The association between AFP response and treatment outcome regarding imaging response and overall survival (OS) was explored. Cox proportional hazards models were applied to identify independent risk factors for OS after TACE.ResultsOf the enrolled 376 patients with elevated serum AFP >20 ng/mL, 214 (57%) with AFP responses were identified. AFP responders had improved median survival than non-responders (20 vs. 12 months, P = 0.002). AFP response was significantly correlated with imaging response (P < 0.001). The Cox proportional hazards model revealed that AFP response was an independent factor for OS (hazard ratio, 0.59; 95% confidence interval, 0.45–0.78; P < 0.001). In stratified analyses, an AFP response achieved improved survival in patients with tumor diameters ≤5 cm, diameters >5 cm, tumor number ≤3 and without underlying cirrhosis.ConclusionsThe AFP response indicates enhanced survival after TACE in patients with intermediate-stage BCLC. |
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Keywords: | Correspondence: Dengbin Wang Department of Radiology Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine No 1665 Kongjiang Road Shanghai 200092 China |
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