Publication
Serum α-Fetoprotein Levels at Time of Recurrence Predict Post-Recurrence Outcomes Following Resection of Hepatocellular Carcinoma
| dc.contributor.author | Tsilimigras, DI | |
| dc.contributor.author | Moris, D | |
| dc.contributor.author | Hyer, JM | |
| dc.contributor.author | Bagante, F | |
| dc.contributor.author | Ratti, F | |
| dc.contributor.author | Marques, HP | |
| dc.contributor.author | Soubrane, O | |
| dc.contributor.author | Lam, V | |
| dc.contributor.author | Poultsides, GA | |
| dc.contributor.author | Popescu, I | |
| dc.contributor.author | Alexandrescu, S | |
| dc.contributor.author | Martel, G | |
| dc.contributor.author | Workneh, A | |
| dc.contributor.author | Guglielmi, A | |
| dc.contributor.author | Hugh, T | |
| dc.contributor.author | Aldrighetti, L | |
| dc.contributor.author | Endo, I | |
| dc.contributor.author | Pawlik, TM | |
| dc.date.accessioned | 2022-11-07T15:25:38Z | |
| dc.date.available | 2022-11-07T15:25:38Z | |
| dc.date.issued | 2021 | |
| dc.description.abstract | Introduction: Although preoperative α-fetoprotein (AFP) has been recognized as an important tumor marker among patients with hepatocellular carcinoma (HCC), the predictive value of AFP levels at the time of recurrence (rAFP) on post-recurrence outcomes has not been well examined. Methods: Patients undergoing curative-intent resection of HCC between 2000 and 2017 were identified using a multi-institutional database. The impact of rAFP on post-recurrence survival, as well as the impact of rAFP relative to the timing and treatment of HCC recurrence were examined. Results: Among 852 patients who underwent resection of HCC, 307 (36.0%) individuals developed a recurrence. The median rAFP level was 8 ng/mL (interquartile range 3-100). Among the 307 patients who developed recurrence, 3-year post-recurrence survival was 48.5%. Patients with rAFP > 10 ng/mL had worse 3-year post-recurrence survival compared with individuals with rAFP < 10 ng/mL (28.7% vs. 65.5%, p < 0.001). rAFP correlated with survival among patients who had early (3-year survival; rAFP > 10 vs. < 10 ng/mL: 30.1% vs. 60.2%, p < 0.001) or late (18.0% vs. 78.7%, p = 0.03) recurrence. Furthermore, rAFP levels predicted 3-year post-recurrence survival among patients independent of the therapeutic modality used to treat the recurrent HCC (rAFP > 10 vs. < 10 ng/mL; ablation: 41.1% vs. 76.0%; intra-arterial therapy: 12.9% vs. 46.1%; resection: 37.5% vs. 100%; salvage transplantation: 60% vs. 100%; all p < 0.05). After adjusting for competing risk factors, patients with rAFP > 10 ng/mL had a twofold higher hazard of death in the post-recurrence setting (hazard ratio 1.96, 95% confidence interval 1.26-3.04). Conclusion: AFP levels at the time of recurrence following resection of HCC predicted post-recurrence survival independent of the secondary treatment modality used. Evaluating AFP levels at the time of recurrence can help inform post-recurrence risk stratification of patients with recurrent HCC. | pt_PT |
| dc.description.version | info:eu-repo/semantics/publishedVersion | pt_PT |
| dc.identifier.citation | Ann Surg Oncol. 2021 Nov;28(12):7673-7683. | pt_PT |
| dc.identifier.doi | 10.1245/s10434-021-09977-x | pt_PT |
| dc.identifier.uri | http://hdl.handle.net/10400.17/4265 | |
| dc.language.iso | eng | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.publisher | Springerlink | pt_PT |
| dc.subject | Hepatocellular Carcinoma | pt_PT |
| dc.subject | Serum α-Fetoprotein Levels | pt_PT |
| dc.subject | HCC CHBPT | pt_PT |
| dc.title | Serum α-Fetoprotein Levels at Time of Recurrence Predict Post-Recurrence Outcomes Following Resection of Hepatocellular Carcinoma | pt_PT |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.endPage | 7683 | pt_PT |
| oaire.citation.issue | 12 | pt_PT |
| oaire.citation.startPage | 7673 | pt_PT |
| oaire.citation.title | Annals of Surgical Oncology | pt_PT |
| oaire.citation.volume | 28 | pt_PT |
| rcaap.rights | openAccess | pt_PT |
| rcaap.type | article | pt_PT |