Publication
Synergistic Impact of Alpha-Fetoprotein and Tumor Burden on Long-Term Outcomes Following Curative-Intent Resection of Hepatocellular Carcinoma
| dc.contributor.author | Tsilimigras, DI | |
| dc.contributor.author | Hyer, JM | |
| dc.contributor.author | Diaz, A | |
| 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 | 2022-11-07T15:47:14Z | |
| dc.date.available | 2022-11-07T15:47:14Z | |
| dc.date.issued | 2021 | |
| dc.description.abstract | Introduction: The prognostic role of tumor burden score (TBS) relative to pre-operative α -fetoprotein (AFP) levels among patients undergoing curative-intent resection of HCC has not been examined. Methods: Patients who underwent curative-intent resection of HCC between 2000 and 2017 were identified from a multi-institutional database. The impact of TBS on overall survival (OS) and cumulative recurrence relative to serum AFP levels was assessed. Results: Among 898 patients, 233 (25.9%) patients had low TBS, 572 (63.7%) had medium TBS and 93 (10.4%) had high TBS. Both TBS (5-year OS; low TBS: 76.9%, medium TBS: 60.9%, high TBS: 39.1%) and AFP (>400 ng/mL vs. <400 ng/mL: 48.5% vs. 66.1%) were strong predictors of outcomes (both p < 0.001). Lower TBS was associated with better OS among patients with both low (5-year OS, low-medium TBS: 68.0% vs. high TBS: 47.7%, p < 0.001) and high AFP levels (5-year OS, low-medium TBS: 53.7% vs. high TBS: not reached, p < 0.001). Patients with low-medium TBS/high AFP had worse OS compared with individuals with low-medium TBS/low AFP (5-year OS, 53.7% vs. 68.0%, p = 0.003). Similarly, patients with high TBS/high AFP had worse outcomes compared with patients with high TBS/low AFP (5-year OS, not reached vs. 47.7%, p = 0.015). Patients with high TBS/low AFP and low TBS/high AFP had comparable outcomes (5-year OS, 47.7% vs. 53.7%, p = 0.24). The positive predictive value of certain TBS groups relative to the risk of early recurrence and 5-year mortality after HCC resection increased with higher AFP levels. Conclusion: Both TBS and serum AFP were important predictors of prognosis among patients with resectable HCC. Serum AFP and TBS had a synergistic impact on prognosis following HCC resection with higher serum AFP predicting worse outcomes among patients with HCC of a certain TBS class. | pt_PT |
| dc.description.version | info:eu-repo/semantics/publishedVersion | pt_PT |
| dc.identifier.citation | Cancers (Basel) . 2021 Feb 11;13(4):747 | pt_PT |
| dc.identifier.doi | 10.3390/cancers13040747 | pt_PT |
| dc.identifier.uri | http://hdl.handle.net/10400.17/4268 | |
| dc.language.iso | eng | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.publisher | Multidisciplinary Digital Publishing Institute (MDPI) | pt_PT |
| dc.subject | AFP | pt_PT |
| dc.subject | HCC | pt_PT |
| dc.subject | Resection | pt_PT |
| dc.subject | Surgery | pt_PT |
| dc.subject | Tumor burden | pt_PT |
| dc.subject | HCC CHBPT | pt_PT |
| dc.title | Synergistic Impact of Alpha-Fetoprotein and Tumor Burden on Long-Term Outcomes Following Curative-Intent Resection of Hepatocellular Carcinoma | pt_PT |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.issue | 4 | pt_PT |
| oaire.citation.startPage | 747 | pt_PT |
| oaire.citation.title | Cancers | pt_PT |
| oaire.citation.volume | 13 | pt_PT |
| rcaap.rights | openAccess | pt_PT |
| rcaap.type | article | pt_PT |