PIVKA-II is a useful marker in patients with modified UICC T3 stage hepatocellular carcinoma.

Abstract

A modified UICC staging system is used in Korea. We evaluated prognostic factors and assessed the survival outcomes for modified UICC T3 stage HCC after surgical resection. We retrospectively reviewed the medical records of 204 patients with HCC who underwent curative hepatectomy between January 2006 and June 2010. The mean tumor size and resection margin were 7.1 ± 3.8 cm and 11.9 ± 11.6 mm, respectively. Portal vein invasion was seen in 68 patients (33.3%), and bile duct invasion was found in 17 patients (8.3%). Two patients (1.0%) died after surgical resection due to the development of decompensated liver failure. The 1-year, 3-year and 5-year disease-free survival rates and overall survival rates were 46.4%, 35.0%, and 26.3%, and 81.7%, 64.7%, and 44.3%, respectively. Multivariate analysis showed that PIVKA-II ≥200 mAU/mL, younger age, and serum albumin levels were closely associated with tumor recurrence with modified UICC T3 stage HCC and that female gender, PIVKA ≥200 mAU/mL, cirrhosis, and serum albumin levels were independent factors for patient survival. PIVKA-II is useful for determining patient survival and the risk of recurrence in modified UICC T3 stage HCC patients.