Postoperative serum α-fetoprotein level is a useful predictor of recurrence after hepatectomy for hepatocellular carcinoma

Abstract

Abstract. We evaluated the clinical value of perioperative ·-fetoprotein (AFP) and des-Á-carboxy prothrombin (DCP) levels in predicting recurrence of hepatocellular carcinoma (HCC) after curative resection, with a focus on the time course as surveillance tools. A total of 165 consecutive HCC patients who had undergone curative hepatectomy at our institution from 2005 to 2007 and whose serum AFP and DCP had been measured before and after hepatectomy were included in this study. The minimum postoperative levels within a 4-month period were used for analysis. Among the patients with a positive level of AFP before operation, the number of patients whose AFP level did not change from positive to negative after operation in the group with recurrence exceeded that in the group without recurrence (48/60, 80.0% vs. 4/23, 17.4%), and the difference was significant (P<0.001). Minimum postoperative AFP level was found to be a significant independent risk factor for recurrence by multivariate analysis (P<0.001). There was no statistically significant correlation between AFP level and grade of hepatitis activity (P=0.599). Postoperative AFP level is a useful tool for predicting recurrence after curative hepatectomy. A positive level of AFP after operation might suggest a site of residual viable cancer. The need for effective adjuvant therapy and close follow-up is suggested in patients with a positive postoperative AFP level.

The Prognostic Value of Alpha-Fetoprotein Ratio in Patients With Resectable Alpha-Fetoprotein-Negative Hepatocellular Carcinoma

“…[14][15][16] Previous studies have reported that a small percentage of initially AFP-negative patients (3.7%) experienced recurrence if they had a positive serum AFP level following surgery, while no recurrence occurred in patients with a consistently negative AFP level after surgery. 17 Our previous study also demonstrated that changes in postoperative AFP levels, even within the normal range, could predict liver cancer recurrence. 6 Another study suggested that models based on AFP variation after surgery, using intelligent algorithms, could predict recurrence in AFP-negative HCC patients.…”

A Model Based on Artificial Intelligence Algorithm for Monitoring Recurrence of HCC after Hepatectomy

“…Serum AFP-negative patients rarely show fluctuations in serum AFP, even if they relapse after surgery; only 3.7% of patients were found to have serum AFP-positive conversion. 15 Therefore, patients who exhibit serum AFP-negative level lack valuable indicators. The present subgroup analysis of serum AFP-positive or -negative levels in patients showed that the HMR model was more effective than the traditional method (serum AFP level) for detecting recurrence in the former, and for AFP-negative patients, the sensitivity and specificity were >70%.…”

“…13,14 A previous study showed that when the preoperative AFP was negative (positive), the sensitivity for detection of HCC recurrence was 3.7% (80.0%). 15 In addition, our previous study found that changes in postoperative AFP levels had higher sensitivity than AFP levels within the normal range. 16 Therefore, the predictive ability of serum AFP for postoperative surveillance is hampered by a high rate of false positives.…”

AFP-L3 for the diagnosis of early hepatocellular carcinoma

“…Tumor markers, as simple and inexpensive indicators, have been widely used in clinical practice. Alpha fetoprotein (AFP), which was discovered in 1963, has become the most important serum marker for diagnose HCC and is also widely used in postoperative recurrence monitoring [6,7] . Unfortunately, the positive rate of AFP expression in HCC is only approximately 70%, [8] and nearly 40% of HCC is AFP-negative [9–11] .…”

“…Alpha fetoprotein (AFP), which was discovered in 1963, has become the most important serum marker for diagnose HCC and is also widely used in postoperative recurrence monitoring. [6,7] Unfortunately, the positive rate of AFP expression in HCC is only approximately 70%, [8] and nearly 40% of HCC is AFP-negative. [9][10][11] Due to the elevation of AFP in some active liver diseases, reproductive system tumors and pregnancy, the diagnostic specificity of AFP for HCC is impacted.…”