Medical College of Wisconsin
CTSIResearch InformaticsREDCap

The prognostic utility of baseline alpha-fetoprotein for hepatocellular carcinoma patients. J Surg Oncol 2017 Dec;116(7):831-840

Date

07/26/2017

Pubmed ID

28743160

DOI

10.1002/jso.24742

Scopus ID

2-s2.0-85026398495 (requires institutional sign-in at Scopus site)   31 Citations

Abstract

INTRODUCTION: Alpha-fetoprotein (AFP) has a valuable role in postoperative surveillance for hepatocellular carcinoma (HCC) recurrence. The utility of pretreatment or baseline AFP remains controversial. The present study hypothesized that elevated baseline AFP levels are associated with worse overall survival in HCC patients.

METHODS: Adult HCC patients were identified using the National Cancer Database (2004-2013). Patients were stratified according to baseline AFP measurements into the following groups: Negative (<20), Borderline (20-199), Elevated (200-1999), and Highly Elevated (>2000). The primary outcome was overall survival (OS), which was analyzed by log-rank test and graphed using Kaplan-Meier method. Multivariate regression modeling was used to determine hazard ratios (HR) for OS.

RESULTS: Of 41 107 patients identified, 15 809 (33.6%) were Negative. Median overall survival was highest in the Negative group, followed by Borderline, Elevated, and Highly Elevated (28.7 vs 18.9 vs 8.8 vs 3.2 months; P < 0.001). On multivariate analysis, overall survival hazard ratios for the Borderline, Elevated, and Highly Elevated groups were 1.18 (P = 0.267), 1.94 (P < 0.001), and 1.77 (P = 0.007), respectively (reference Negative).

CONCLUSION: Baseline AFP independently predicted overall survival in HCC patients regardless of treatment plan. A baseline AFP value is a simple and effective method to assist in expected survival for HCC patients.

Author List

Silva JP, Gorman RA, Berger NG, Tsai S, Christians KK, Clarke CN, Mogal H, Gamblin TC

Authors

Kathleen K. Christians MD Professor in the Surgery department at Medical College of Wisconsin
Callisia N. Clarke MD Chief, Associate Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aged
Carcinoma, Hepatocellular
Cohort Studies
Humans
Liver Neoplasms
Middle Aged
Predictive Value of Tests
Prognosis
Retrospective Studies
Survival Rate
United States
alpha-Fetoproteins