High pretreatment static and dynamic alpha‐fetoprotein values predict reduced overall survival in hepatocellular carcinoma

Autor: Christoph Düber, Sandra Koch, Jens U. Marquardt, Gerd Otto, Roman Kloeckner, Martin F. Sprinzl, Irene Schmidtmann, Hauke Lang, Marcus A. Wörns, Lukas Pilz, Sophia Heinrich, Peter R. Galle, Arndt Weinmann, Carolin Czauderna, Jens Mittler
Rok vydání: 2021
Předmět:
Zdroj: United European Gastroenterology Journal
ISSN: 2050-6414
2050-6406
DOI: 10.1177/2050640620972611
Popis: Background Hepatocellular carcinoma is one of the most lethal cancers worldwide. Novel prognostic and/or predictive biomarkers are urgently needed to improve patient management. Alpha‐fetoprotein (AFP) is a well‐established and widely used biomarker for hepatocellular carcinoma. However, diagnostic accuracy of static AFP values is limited and the clinical potential is a matter of ongoing scientific discussion. Objective We here evaluated the prognostic impact of pretreatment static and dynamic AFP variables on overall survival of hepatocellular carcinoma patients in a Western cohort. Methods Patients with confirmed hepatocellular carcinoma (n = 809) treated at the Johannes Gutenberg University Mainz between 1998 and 2014 and two available pretreatment AFP‐values (AFP‐slope) were retrospectively analysed. Clinicopathological baseline parameters, pretreatment static values and AFP‐slope were assessed. Prognostic impact was determined by Kaplan–Meier analyses and Cox regression models. Results High static and dynamic AFP variables prior to therapy were associated with reduced survival rates of hepatocellular carcinoma patients. Several known clinical parameters such as Child–Pugh B (p < 0.01) and C stage (p
Key Summary Alpha‐fetoprotein (AFP) is the most commonly used biomarker for hepatocellular carcinomas (HCCs), but accuracy of static and dynamic AFP values is limited and the prognostic significance is under debate.High static and dynamic AFP variables prior to therapy are associated with reduced survival rates of HCC patients across different tumour stages and treatment modalities.In patients with more favourable prognosis, AFP‐slope prior to therapy was a better predictor for overall survival in comparison with static AFP values.Addition of AFP‐slope to established prognostic parameters might improve prognostic classification for a subgroup of HCC.
Databáze: OpenAIRE
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