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Prognostic value of alpha-fetoprotein in patients who achieve a complete response to transarterial chemoembolization for hepatocellular carcinoma

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dc.contributor.authorLee, JS-
dc.contributor.authorChon, YE-
dc.contributor.authorKim, BK-
dc.contributor.authorPark, JY-
dc.contributor.authorKim, DY-
dc.contributor.authorAhn, SH-
dc.contributor.authorHan, KH-
dc.contributor.authorKang, W-
dc.contributor.authorChoi, MS-
dc.contributor.authorGwak, GY-
dc.contributor.authorPaik, YH-
dc.contributor.authorLee, JH-
dc.contributor.authorKoh, KC-
dc.contributor.authorPaik, SW-
dc.contributor.authorKim, HY-
dc.contributor.authorKim, TH-
dc.contributor.authorYoo, K-
dc.contributor.authorHa, Y-
dc.contributor.authorKim, MN-
dc.contributor.authorLee, JH-
dc.contributor.authorHwang, SG-
dc.contributor.authorKim, SS-
dc.contributor.authorCho, HJ-
dc.contributor.authorCheong, JY-
dc.contributor.authorCho, SW-
dc.contributor.authorPark, SH-
dc.contributor.authorHeo, NY-
dc.contributor.authorHong, YM-
dc.contributor.authorYoon, KT-
dc.contributor.authorCho, M-
dc.contributor.authorPark, JG-
dc.contributor.authorKang, MK-
dc.contributor.authorPark, SY-
dc.contributor.authorKweon, YO-
dc.contributor.authorTak, WY-
dc.contributor.authorJang, SY-
dc.contributor.authorSinn, DH-
dc.contributor.authorKim, SU-
dc.contributor.authorKorean TACE Study Group-
dc.date.accessioned2023-01-05T03:03:18Z-
dc.date.available2023-01-05T03:03:18Z-
dc.date.issued2021-
dc.identifier.issn0513-5796-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/23658-
dc.description.abstractPurpose: Alpha-fetoprotein (AFP) is a prognostic marker for hepatocellular carcinoma (HCC). We investigated the prognostic value of AFP levels in patients who achieved complete response (CR) to transarterial chemoembolization (TACE) for HCC. Materials and Methods: Between 2005 and 2018, 890 patients with HCC who achieved a CR to TACE were recruited. An AFP re-sponder was defined as a patient who showed elevated levels of AFP (>10 ng/mL) during TACE, but showed normalization or a >50% reduction in AFP levels after achieving a CR. Results: Among the recruited patients, 569 (63.9%) with naïve HCC and 321 (36.1%) with recurrent HCC after complete resection were treated. Before TACE, 305 (34.3%) patients had multiple tumors, 219 (24.6%) had a maximal tumor size >3 cm, and 22 (2.5%) had portal vein tumor thrombosis. The median AFP level after achieving a CR was 6.36 ng/mL. After a CR, 473 (53.1%) patients experienced recurrence, and 417 (46.9%) died [median progression-free survival (PFS) and overall survival (OS) of 16.3 and 62.8 months, respectively]. High AFP levels at CR (>20 ng/mL) were independently associated with a shorter PFS [hazard ratio (HR)=1.403] and OS (HR=1.284), together with tumor multiplicity at TACE (HR=1.518 and 1.666, respectively). AFP non-respond-ers at CR (76.2%, n=359 of 471) showed a shorter PFS (median 10.5 months vs. 15.5 months, HR=1.375) and OS (median 41.4 months vs. 61.8 months, HR=1.424) than AFP responders (all p=0.001). Conclusion: High AFP levels and AFP non-responders were independently associated with poor outcomes after TACE. AFP holds clinical implications for detailed risk stratification upon achieving a CR after TACE.-
dc.formatapplication/pdf-
dc.language.isoen-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHalpha-Fetoproteins-
dc.subject.MESHArteries-
dc.subject.MESHCarcinoma, Hepatocellular-
dc.subject.MESHChemoembolization, Therapeutic-
dc.subject.MESHFemale-
dc.subject.MESHHumans-
dc.subject.MESHLiver Neoplasms-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHPrognosis-
dc.subject.MESHProportional Hazards Models-
dc.subject.MESHRecurrence-
dc.subject.MESHTreatment Outcome-
dc.subject.MESHVenous Thrombosis-
dc.titlePrognostic value of alpha-fetoprotein in patients who achieve a complete response to transarterial chemoembolization for hepatocellular carcinoma-
dc.typeArticle-
dc.identifier.pmid33381930-
dc.identifier.urlhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7820452/-
dc.subject.keywordAlpha-fetoprotein-
dc.subject.keywordPrognosis-
dc.subject.keywordTransarterial chemoembolization-
dc.subject.keywordTreatment outcome-
dc.subject.keywordcarcinoma, hepatocellular-
dc.contributor.affiliatedAuthor김, 순선-
dc.contributor.affiliatedAuthor조, 효정-
dc.contributor.affiliatedAuthor정, 재연-
dc.type.localJournal Papers-
dc.identifier.doi10.3349/ymj.2021.62.1.12-
dc.citation.titleYonsei medical journal-
dc.citation.volume62-
dc.citation.number1-
dc.citation.date2021-
dc.citation.startPage12-
dc.citation.endPage20-
dc.identifier.bibliographicCitationYonsei medical journal, 62(1). : 12-20, 2021-
dc.identifier.eissn1976-2437-
dc.relation.journalidJ005135796-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Gastroenterology
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