Changes of alpha-fetoprotein levels could predict recurrent hepatocellular carcinoma survival after trans-arterial chemoembolization.
Changes of alpha-fetoprotein levels could predict recurrent hepatocellular carcinoma survival after trans-arterial chemoembolization.
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DOI：
10.18632/oncotarget.20343
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发表时间：
2017-10-17
期刊：
影响因子：
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通讯作者：
Lu W
中科院分区：
文献类型：
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作者：
He C;Zhang X;Li C;Peng W;Wen TF;Yan LN;Yang J;Lu W
关于 AFP 变化是否可以预测经动脉化疗栓塞 (TACE) 后复发性肝细胞癌 (RHCC) 患者的预后，目前的信息很少。回顾性分析 177 例接受 TACE 作为一线治疗的 RHCC 患者。根据TACE前和TACE后AFP水平将患者分为三组（A组：AFP下降，B组：AFP一致正常，C组：AFP升高）。采用Kaplan-Meier法估计复发至死亡生存率（RTDS）和总生存率（OS），并通过时序检验进行比较。进行多变量分析以确定 OS 和 RTDS 的预后因素。三组之间的基线特征没有显着差异。 A组的中位总生存期（OS）为74.5个月（95%置信区间（CI）：63.5，85.6），B组为64.0个月（95% CI：52.3，75.7），C组为29.0个月（95% CI：24.1，33.9；P<0.001）。 A 组的中位复发至死亡生存期 (RTDS) 为 66.5 个月（95% CI：53.4，79.6），B 组为 50.4 个月（95% CI：39.5，61.4），C 组为 17.7 个月（95% CI：13.4，22.1；P<0.001）。复发期人数、TACE 周期、mRECIST 反应和 TACE 后 AFP 变化是 RTDS 和 OS 的显着独立危险因素。 AFP的变化可以预测接受动脉化疗栓塞治疗的RHCC患者的预后，这可能有助于临床医生做出后续的治疗决策。
There is paucity of information concerning whether AFP change is a predictor of prognosis for recurrent hepatocellular carcinoma (RHCC) patients after trans-arterial chemoembolization (TACE). A total of 177 RHCC patients who received TACE as first-line therapy were retrospectively analyzed. The patients were classified into three groups according to their pre-TACE and post-TACE AFP levels (group A: AFP decreased, group B: AFP consistent normal, and group C: AFP increased). The recurrence to death survival (RTDS) and overall survival (OS) were estimated by the Kaplan-Meier method, and compared by the log-rank test. Multivariate analyses were performed to identify prognostic factors for OS and RTDS. There was no significant difference among the three groups concerning the baseline characteristics. The median overall survival (OS) was 74.5 months in group A (95% confidence interval (CI): 63.5, 85.6), 64.0 months in group B (95% CI: 52.3, 75.7) and 29.0 months in group C (95% CI: 24.1, 33.9; P<0.001). The median recurrence to death survival (RTDS) was 66.5 months (95% CI: 53.4, 79.6) in group A, 50.4 months (95% CI: 39.5, 61.4) in group B and 17.7 months (95% CI: 13.4, 22.1; P<0.001) in group C. Multivariate analysis revealed that tumor size at resection stage, tumor number at recurrent stage, cycles of TACE, mRECIST response and AFP change after TACE were significant independent risk factors for RTDS and OS. AFP change could predict the prognoses of patients with RHCC who received trans-arterial chemoembolization, which may help clinicians make subsequent treatment decision.