Sunyoung Lee, Hyunchul Rhim*, Young-sun Kim, Tae Wook Kang andKyoung Doo Song
DOI: 10.1111/liv.12991
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Cover image for Vol. 35 Issue 11
Liver International
Accepted Article (Accepted, unedited articles published online and citable. The final edited and typeset version of record will appear in future.)
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Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
* Correspondence to Hyunchul Rhim, MD
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea
Tel: +82-2-3410-2507
Fax: +82-2-3410-2559
E-mail: [email protected]
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/liv.12991
Keywords:
Hepatitis B virus;Hepatocellular carcinoma;Radiofrequency ablation;des-gamma-carboxy prothrombin
Abstract
Background & Aims
We investigated whether pre- or postablation serum alpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) levels can predict prognosis in patients with curative radiofrequency ablation (RFA) for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).
Methods
We retrospectively analyzed 412 patients with HBV-related single HCC treated with percutaneous RFA between January 2004 and December 2013. AFP and DCP levels were measured before (preablation) and 1 month after treatment (postablation). We assessed predictive factors for overall and recurrence-free survival.
Results
On univariate analysis, Child-Pugh score, MELD score, platelet count, tumor size, Barcelona Clinic Liver Cancer (BCLC) stage, and pre- and postablation DCP were significant for overall survival; and age, Child-Pugh score, MELD score, platelet count, tumor size, Cancer of the Liver Italian Program (CLIP) score, BCLC stage, and pre- and postablation AFP and DCP were significant for recurrence-free survival. Multivariate analysis revealed significant differences in overall survival by MELD score and tumor size and in recurrence-free survival by BCLC stage. Among the tumor markers, postablation DCP was an independent prognostic factor for overall and recurrence-free survival (hazard ratio [HR], 3.438; 95% confidence interval [CI], 1.331–8.877; p = 0.011 and HR, 4.934; 95% CI, 2.761–8.816; p < 0.001, respectively). Postablation AFP was associated with recurrence-free survival (HR, 1.995; 95% CI, 1.476–2.697; p <0.001) but not overall survival.
Conclusions
In patients with HBV-related HCC, postablation serum DCP is a useful biomarker for predicting survival and recurrence after curative RFA.
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