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Prediction of Tumor Recurrence by α-Fetoprotein Model after Curative Resection for Hepatocellular Carcinoma

2021Journal article Open access
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dc.contributor.authorDing, HF
dc.contributor.authorZhang, XF
dc.contributor.authorBagante, F
dc.contributor.authorRatti, F
dc.contributor.authorPinto Marques, H
dc.contributor.authorSoubrane, O
dc.contributor.authorLam, V
dc.contributor.authorPoultsides, G
dc.contributor.authorPopescu, I
dc.contributor.authorAlexandrescu, S
dc.contributor.authorMartel, G
dc.contributor.authorWorkneh, A
dc.contributor.authorGuglielmi, A
dc.contributor.authorHugh, T
dc.contributor.authorAldrighetti, L
dc.contributor.authorLv, Y
dc.contributor.authorPawlik, T
dc.date.accessioned2022-12-07T16:06:24Z
dc.date.available2022-12-07T16:06:24Z
dc.date.issued2021
dc.description.abstractBackground: Preoperative α-fetoprotein (AFP) level levels may help select patients with hepatocellular carcinoma (HCC) for surgery. The objective of the current study was to assess an AFP model to predict tumor recurrence and patient survival after curative resection for HCC. Methods: Patients undergoing curative-intent resection for HCC between 2000 and 2017 were identified from a multi-institutional database. AFP score was calculated based on the last evaluation before surgery. Probabilities of tumor recurrence and overall survival (OS) were compared according to an AFP model. Results: A total of 825 patients were included. An optimal cut-off AFP score of 2 was identified with an AFP score ≥3 versus ≤2 independently predicting tumor recurrence and OS. Net reclassification improvements indicated the AFP model was superior to the Barcelona Clinic Liver Cancer (BCLC) system to predict recurrence (p < 0.001). Among patients with BCLC B-C, AFP score ≤2 identified a subgroup of patients with AFP levels of ≤100 ng/mL with a low 5-year recurrence risk (≤2 45.2% vs. ≥3 61.8%, p = 0.046) and favorable 5-year OS (≤2 54.5% vs. ≥3 39.4%, p = 0.035). In contrast, among patients within BCLC 0-A, AFP score ≥3 identified a subgroup of patients with AFP values > 1000 ng/mL with a high 5-year recurrence (≥3 47.9% vs. ≤2% 38.4%, p = 0.046) and worse 5-year OS (≥3 47.8% vs. ≤2 65.9%, p < 0.001). In addition, the AFP score independently correlated with vascular invasion, tumor differentiation and capsule invasion. Conclusions: The AFP model was more accurate than the BCLC system to identify which HCC patients may benefit the most from surgical resection.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationEur J Surg Oncol. 2021 Mar;47(3 Pt B):660-666pt_PT
dc.identifier.doi10.1016/j.ejso.2020.10.017pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4308
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectHCC CIRpt_PT
dc.subjectAgedpt_PT
dc.subjectFemalept_PT
dc.subjectMalept_PT
dc.subjectHumanspt_PT
dc.subjectCarcinoma, Hepatocellular / metabolismpt_PT
dc.subjectMiddle Agedpt_PT
dc.subjectCarcinoma, Hepatocellular / mortalitypt_PT
dc.subjectCarcinoma, Hepatocellular / pathologypt_PT
dc.subjectCarcinoma, Hepatocellular / surgery*pt_PT
dc.subjectLiver Neoplasms / metabolismpt_PT
dc.subjectLiver Neoplasms / mortalitypt_PT
dc.subjectLiver Neoplasms / pathologypt_PT
dc.subjectLiver Neoplasms / surgery*pt_PT
dc.subjectNeoplasm Invasivenesspt_PT
dc.subjectNeoplasm Recurrence, Local*pt_PT
dc.subjectNeoplasm Stagingpt_PT
dc.subjectPrognosispt_PT
dc.subjectSurvival Ratept_PT
dc.subjectalpha-Fetoproteins / metabolism*pt_PT
dc.titlePrediction of Tumor Recurrence by α-Fetoprotein Model after Curative Resection for Hepatocellular Carcinomapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage666pt_PT
oaire.citation.startPage660pt_PT
oaire.citation.titleEuropean Journal of Surgical Oncologypt_PT
oaire.citation.volume47pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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