Detalhes bibliográficos
| Resumo: | Background: Preoperative α-fetoprotein (AFP) level levels may help select patients with hepatocellular carcinoma (HCC) for surgery. The objective of the current study was to assess an AFP model to predict tumor recurrence and patient survival after curative resection for HCC. Methods: Patients undergoing curative-intent resection for HCC between 2000 and 2017 were identified from a multi-institutional database. AFP score was calculated based on the last evaluation before surgery. Probabilities of tumor recurrence and overall survival (OS) were compared according to an AFP model. Results: A total of 825 patients were included. An optimal cut-off AFP score of 2 was identified with an AFP score ≥3 versus ≤2 independently predicting tumor recurrence and OS. Net reclassification improvements indicated the AFP model was superior to the Barcelona Clinic Liver Cancer (BCLC) system to predict recurrence (p < 0.001). Among patients with BCLC B-C, AFP score ≤2 identified a subgroup of patients with AFP levels of ≤100 ng/mL with a low 5-year recurrence risk (≤2 45.2% vs. ≥3 61.8%, p = 0.046) and favorable 5-year OS (≤2 54.5% vs. ≥3 39.4%, p = 0.035). In contrast, among patients within BCLC 0-A, AFP score ≥3 identified a subgroup of patients with AFP values > 1000 ng/mL with a high 5-year recurrence (≥3 47.9% vs. ≤2% 38.4%, p = 0.046) and worse 5-year OS (≥3 47.8% vs. ≤2 65.9%, p < 0.001). In addition, the AFP score independently correlated with vascular invasion, tumor differentiation and capsule invasion. Conclusions: The AFP model was more accurate than the BCLC system to identify which HCC patients may benefit the most from surgical resection. |
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| Autores principais: | Ding, HF |
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| Outros Autores: | Zhang, XF; Bagante, F; Ratti, F; Pinto Marques, H; Soubrane, O; Lam, V; Poultsides, G; Popescu, I; Alexandrescu, S; Martel, G; Workneh, A; Guglielmi, A; Hugh, T; Aldrighetti, L; Lv, Y; Pawlik, T |
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| Assunto: | HCC CIR Aged Female Male Humans Carcinoma, Hepatocellular / metabolism Middle Aged Carcinoma, Hepatocellular / mortality Carcinoma, Hepatocellular / pathology Carcinoma, Hepatocellular / surgery* Liver Neoplasms / metabolism Liver Neoplasms / mortality Liver Neoplasms / pathology Liver Neoplasms / surgery* Neoplasm Invasiveness Neoplasm Recurrence, Local* Neoplasm Staging Prognosis Survival Rate alpha-Fetoproteins / metabolism* |
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| Ano: | 2021 |
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| País: | Portugal |
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| Tipo de documento: | artigo |
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| Tipo de acesso: | acesso aberto |
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| Instituição associada: | Centro Hospitalar de Lisboa Central, EPE (CHLC) |
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| Idioma: | inglês |
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| Origem: | Repositório do Centro Hospitalar de Lisboa Central, EPE |
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