Abstract
BackgroundWe evaluated treatment modalities and survival in patients with hepatocellular carcinoma (HCC), by pre-treatment and 3-month post-treatment serum alpha-fetoprotein (AFP) levels and pre-treatment tumor diameters.MethodsWe retrospectively reviewed 57 patients treated for HCC in our department from January 2002 to December 2012, including their sex, type of hepatitis, Child class, pre-treatment tumor size, pre-treatment levels of albumin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), red blood cells, hemoglobin, and total bilirubin, pre- and 3-month post-treatment serum AFP, and treatment modality (transarterial chemoembolization, resection or radiofrequency ablation). Survival was analyzed at 1, 3, and 5 years after treatment.ResultsThe 57 patients included 44 men and 13 women, of whom 44 had hepatitis C virus (HCV) infection, 3 had hepatitis B virus (HBV) infection, 3 had both HBV and HCV infection, 1 had both HBV and hepatitis D virus infection, and 3 had alcohol-related liver cirrhosis. Both pre- and post-treatment serum AFP levels significantly correlated with recurrent tumor size (P < 0.05 for both). Pre-treatment tumor size did not correlate with recurrent tumor size. Patients who underwent hepatic resection survived significantly longer than those who underwent transarterial chemoembolization or radiofrequency ablation (P < 0.05).ConclusionsSerum AFP level is useful in diagnosing tumor recurrence and predicting prognosis in HCC patients treated by hepatic resection, transarterial chemoembolization, and radiofrequency ablation. Hepatic resection remains the treatment of choice for HCC in suitable patients.
Highlights
We evaluated treatment modalities and survival in patients with hepatocellular carcinoma (HCC), by pre-treatment and 3-month post-treatment serum alpha-fetoprotein (AFP) levels and pre-treatment tumor diameters
A total of 103 HCC patients were observed during the study period, of whom 46 patients were excluded (27 were in Child class C and 19 who had no indication for surgery refused to undergo radiofrequency ablation (RFA) and transarterial chemoembolization (TACE))
57 patients were included in the study, of whom 44 were men (77.2%) and 13 were women (22.8%), aged 40–86 years; 25 had Child Class A disease and 32 had class B disease; 44 patients (77.2%) had hepatitis C virus (HCV) infection, 3 (5.3%) had hepatitis B virus (HBV) infection, 3 (5.3%) had both HBV and HCV infection, and 1 (1.7%) had both HBV and hepatitis D virus infection
Summary
We evaluated treatment modalities and survival in patients with hepatocellular carcinoma (HCC), by pre-treatment and 3-month post-treatment serum alpha-fetoprotein (AFP) levels and pre-treatment tumor diameters. Serum AFP level may be high in patients with drug or alcohol abuse or with chronic liver disease such as hepatitis or cirrhosis, but in these cases, the level is usually 200 ng/mL to be diagnostic for HCC [2]. Some studies have suggested using a serum AFP level of >400 ng/mL to diagnose HCC [5], or a solid mass >2 cm in diameter with typical features of HCC on at least one imaging study in a patient with liver cirrhosis [2]
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