Prognostic Role of Serum Alpha-Fetoprotein in Hepatocellular Carcinoma Patients with Radiofrequency Ablation

Abstract

Background and study aim: Prognostic value of serum alpha-fetoprotein (AFP) in hepatocellular carcinoma (HCC) is still debatable. We aimed to study this role in HCC patients who underwent radiofrequency ablation (RFA). Materials and Methods: Records from HCC patients were retrospectively analyzed between January 2012 and December 2016. A minimum data set for each patient record of a follow-up period of at least 1 year was pre-defined before enrollment. In all, 153 patients were enrolled. AFP levels were recorded for all patients at the time of diagnosis, 1 month after RFA and at 3-month intervals afterward. Patients were divided according to pretreatment AFP level into 3 groups: group 1: AFP <20 ng/mL, group 2: AFP 20-200 ng/mL and group 3: AFP >200 ng/mL. Results: Pretreatment AFP is not significantly correlated with age, baseline lesion number or size, baseline Child score or class, post RFA recurrence or death. The overall survival rates were 95%, 75.6%, 55.6%, 48.8%, and 48.8% at 1,2,3,4, and 5 years respectively. On comparing the 3 groups on disease-free survival, there was no statistically significant difference among the three classes. Child class A patients showed statistically significant better survival after RFA than those with Child class B. The ROC curve showed that AFP had inadequate accuracy to discriminate survivors and deceased patients and to discriminate patients with recurrence from those without recurrence. Conclusion: AFP level could not be used as a good predictor of either death or recurrence of HCC after RFA