Author:
Zhang Jie,Qin Shang Dong,Li Yan,Lu Fei,Gong Wen Feng,Zhong Jian Hong,Ma Liang,Zhao Jing Fei,Zhan Guo Hua,Li Peng Zhan,Song Bin,De Xiang Bang
Abstract
Abstract
Background
The prognosis of hepatocellular carcinoma (HCC) varies considerably among patients with the same disease stage and characteristics, and only about two thirds show high levels of α-fetoprotein (AFP), a common prognostic indicator for HCC. Here, we assessed whether the combination of presurgical serum levels of AFP and carbohydrate antigen 19-9 (CA19-9) can predict the prognosis of HCC patients after hepatectomy.
Methods
The clinicopathological characteristics and post-hepatectomy outcomes of 711 HCC patients were retrospectively reviewed. The patients were classified into three groups based on whether their preoperative serum levels of both AFP and CA19-9 were higher than the respective cut-offs of 400 ng/ml and 37 U/ml [double positive (DP)], the level of only one marker was higher than the cut-off [single positive (SP)], or neither level was higher than the cut-off [negative (N)]. The overall survival (OS) and recurrence-free survival (RFS) rates were estimated using Kaplan–Meier curves. Univariate and multivariate survival analyses were performed to identify the clinicopathological factors significantly associated with HCC prognosis.
Results
The 1-year, 3-year, and 5-year RFS and OS rates in the N group were significantly higher than those in the SP group, while the DP group showed the lowest rates. Multivariate Cox regression analysis showed that large tumor size (> 5 cm), multiple tumors (≥ 2), incomplete tumor capsule, positive microvascular invasion, Barcelona Clinic Liver Cancer C stage, and CA19-9 level > 37 U/mL were independent risk factors for RFS and OS in HCC patients. Moreover, aspartate aminotransferase levels > 40 U/L proved to be an independent prognostic factor for OS.
Conclusion
The combination of serum AFP and CA19-9 levels may be a useful prognostic marker for HCC patients after hepatectomy.
Funder
Youth Program of Scientific Research Foundation of Guangxi Medical University Cancer Hospital
National Natural Science Foundation of China
“139” Projects for Training of High-level Medical Science Talents from Guangxi
the Key Research and Development Project of Guangxi
Publisher
Springer Science and Business Media LLC
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