Detailed Abstract
[Liver Oral Presentation 3]
[LV OP 3-2] Association of postoperative biomarker response with recurrence and survival in patients with hepatocellular carcinoma and high alpha-fetoprotein expressions (> 400 ng/ml)
Ming-Da WANG1, Lei LIANG2, Cheng-Wu ZHANG2, Wan Yee LAU1, 3, Feng SHEN1, Timothy M. PAWLIK4, Dong-Sheng HUANG2, Tian YANG*1, 2
1Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), China
2Department of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, China
3Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
4Department of Surgery, Ohio State University, Wexner Medical Center, Columbus, OH, USA
Introduction : 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.
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 (2.97; 2.49~3.45; P<0.001) and RFS (4.29; 3.31~5.55; P<0.001).
Conclusions : 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.
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.
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 (2.97; 2.49~3.45; P<0.001) and RFS (4.29; 3.31~5.55; P<0.001).
Conclusions : 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.
SESSION
Liver Oral Presentation 3
Room A 3/26/2021 8:07 AM - 8:14 AM