Skip to main content
Erschienen in: Surgery Today 12/2015

01.12.2015 | Original Article

The tumor marker score is an independent predictor of survival in patients with recurrent hepatocellular carcinoma

verfasst von: Yukiyasu Okamura, Ryo Ashida, Takaaki Ito, Teiichi Sugiura, Keita Mori, Katsuhiko Uesaka

Erschienen in: Surgery Today | Ausgabe 12/2015

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Alpha-fetoprotein (AFP) and des-γ-carboxy prothrombin (DCP) are prognostic factors for hepatocellular carcinoma (HCC). The impact of these tumor markers in recurrent HCC on the prognosis remains to be fully elucidated.

Methods

Two hundred and seventeen patients whose AFP and DCP levels were measured at recurrence were enrolled in the present study. AFP levels >10 ng/mL and DCP levels ≥40 mAU/mL were defined as AFP positive (AFP+) and DCP positive (DCP+), respectively. The patterns of tumor markers were scored as AFP−/DCP−, 0; AFP+/DCP− or AFP−/DCP+, 1 and AFP+/DCP+, 2.

Results

The median survival period after recurrence in patients with a score of 2 (26.6 months) was significantly lower than that in patients with scores of 1 or 0 (43.5 months, P < 0.01; 75.3 months, P < 0.01, respectively). A multivariate analysis showed that a tumor marker score of 2 at recurrence was an independent predictor for poor survival after recurrence (hazard ratio 2.12, P = 0.03). The prognosis after recurrence in the patients with a decreased tumor maker score was significantly better than that in the patients with no change in the tumor marker score compared to the primary surgery (P = 0.048).

Conclusions

The present study shows that measurements of both AFP and DCP are useful for predicting the prognosis of recurrent HCC.
Literatur
1.
Zurück zum Zitat Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61:212–36.CrossRefPubMed Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61:212–36.CrossRefPubMed
2.
Zurück zum Zitat Shimada M, Takenaka K, Gion T, Fujiwara Y, Kajiyama K, Maeda T, et al. Prognosis of recurrent hepatocellular carcinoma: a 10-year surgical experience in Japan. Gastroenterology. 1996;111:720–6.CrossRefPubMed Shimada M, Takenaka K, Gion T, Fujiwara Y, Kajiyama K, Maeda T, et al. Prognosis of recurrent hepatocellular carcinoma: a 10-year surgical experience in Japan. Gastroenterology. 1996;111:720–6.CrossRefPubMed
3.
Zurück zum Zitat Poon RT, Fan ST, Lo CM, Liu CL, Wong J. Intrahepatic recurrence after curative resection of hepatocellular carcinoma: long-term results of treatment and prognostic factors. Ann Surg. 1999;229:216–22.PubMedCentralCrossRefPubMed Poon RT, Fan ST, Lo CM, Liu CL, Wong J. Intrahepatic recurrence after curative resection of hepatocellular carcinoma: long-term results of treatment and prognostic factors. Ann Surg. 1999;229:216–22.PubMedCentralCrossRefPubMed
4.
Zurück zum Zitat Kobayashi K, Ishiyama K, Ohdan H. Prevention of recurrence after curative treatment for hepatocellular carcinoma. Surg Today. 2013;43:1347–54.CrossRefPubMed Kobayashi K, Ishiyama K, Ohdan H. Prevention of recurrence after curative treatment for hepatocellular carcinoma. Surg Today. 2013;43:1347–54.CrossRefPubMed
5.
Zurück zum Zitat Liaw YF, Tai DI, Chu CM, Lin DY, Sheen IS, Chen TJ, et al. Early detection of hepatocellular carcinoma in patients with chronic type B hepatitis: a prospective study. Gastroenterology. 1986;90:263–7.PubMed Liaw YF, Tai DI, Chu CM, Lin DY, Sheen IS, Chen TJ, et al. Early detection of hepatocellular carcinoma in patients with chronic type B hepatitis: a prospective study. Gastroenterology. 1986;90:263–7.PubMed
6.
Zurück zum Zitat Debruyne EN, Delanghe JR. Diagnosing and monitoring hepatocellular carcinoma with alpha-fetoprotein: new aspects and applications. Clin Chim Acta. 2008;395:19–26.CrossRefPubMed Debruyne EN, Delanghe JR. Diagnosing and monitoring hepatocellular carcinoma with alpha-fetoprotein: new aspects and applications. Clin Chim Acta. 2008;395:19–26.CrossRefPubMed
7.
Zurück zum Zitat Liebman HA, Furie BC, Tong MJ, Blanchard RA, Lo KJ, Lee SD, et al. Des-gamma-carboxy (abnormal) prothrombin as a serum marker of primary hepatocellular carcinoma. N Engl J Med. 1984;310:1427–31.CrossRefPubMed Liebman HA, Furie BC, Tong MJ, Blanchard RA, Lo KJ, Lee SD, et al. Des-gamma-carboxy (abnormal) prothrombin as a serum marker of primary hepatocellular carcinoma. N Engl J Med. 1984;310:1427–31.CrossRefPubMed
8.
Zurück zum Zitat Okuda H, Obata H, Nakanishi T, Furukawa R, Hashimoto E. Production of abnormal prothrombin (des-gamma-carboxy prothrombin) by hepatocellular carcinoma. A clinical and experimental study. J Hepatol. 1987;4:357–63.CrossRefPubMed Okuda H, Obata H, Nakanishi T, Furukawa R, Hashimoto E. Production of abnormal prothrombin (des-gamma-carboxy prothrombin) by hepatocellular carcinoma. A clinical and experimental study. J Hepatol. 1987;4:357–63.CrossRefPubMed
9.
Zurück zum Zitat Shimada M, Takenaka K, Fujiwara Y, Gion T, Kajiyama K, Maeda T, et al. Des-gamma-carboxy prothrombin and alpha-fetoprotein positive status as a new prognostic indicator after hepatic resection for hepatocellular carcinoma. Cancer. 1996;78:2094–100.CrossRefPubMed Shimada M, Takenaka K, Fujiwara Y, Gion T, Kajiyama K, Maeda T, et al. Des-gamma-carboxy prothrombin and alpha-fetoprotein positive status as a new prognostic indicator after hepatic resection for hepatocellular carcinoma. Cancer. 1996;78:2094–100.CrossRefPubMed
10.
Zurück zum Zitat Nakao A, Taniguchi K, Inoue S, Harada A, Nonami T, Watanabe K, et al. Usefulness of simultaneous determination of alpha-fetoprotein and des-gamma-carboxy prothrombin in hepatocellular carcinoma. Semin Surg Oncol. 1996;12:160–3.CrossRefPubMed Nakao A, Taniguchi K, Inoue S, Harada A, Nonami T, Watanabe K, et al. Usefulness of simultaneous determination of alpha-fetoprotein and des-gamma-carboxy prothrombin in hepatocellular carcinoma. Semin Surg Oncol. 1996;12:160–3.CrossRefPubMed
11.
Zurück zum Zitat Yamamoto K, Imamura H, Matsuyama Y, Hasegawa K, Beck Y, Sugawara Y, et al. Significance of alpha-fetoprotein and des-gamma-carboxy prothrombin in patients with hepatocellular carcinoma undergoing hepatectomy. Ann Surg Oncol. 2009;16:2795–804.CrossRefPubMed Yamamoto K, Imamura H, Matsuyama Y, Hasegawa K, Beck Y, Sugawara Y, et al. Significance of alpha-fetoprotein and des-gamma-carboxy prothrombin in patients with hepatocellular carcinoma undergoing hepatectomy. Ann Surg Oncol. 2009;16:2795–804.CrossRefPubMed
12.
Zurück zum Zitat Kaibori M, Matsui Y, Yanagida H, Yokoigawa N, Kwon AH, Kamiyama Y. Positive status of alpha-fetoprotein and des-gamma-carboxy prothrombin: important prognostic factor for recurrent hepatocellular carcinoma. World J Surg. 2004;28:702–7.CrossRefPubMed Kaibori M, Matsui Y, Yanagida H, Yokoigawa N, Kwon AH, Kamiyama Y. Positive status of alpha-fetoprotein and des-gamma-carboxy prothrombin: important prognostic factor for recurrent hepatocellular carcinoma. World J Surg. 2004;28:702–7.CrossRefPubMed
13.
Zurück zum Zitat Hirohashi K, Shuto T, Kubo S, Tanaka H, Yamamoto T, Ikebe T, et al. Prognostic factors after recurrence of resected hepatocellular carcinoma associated with hepatitis C virus. J Hepatobiliary Pancreat Surg. 2001;8:81–6.CrossRefPubMed Hirohashi K, Shuto T, Kubo S, Tanaka H, Yamamoto T, Ikebe T, et al. Prognostic factors after recurrence of resected hepatocellular carcinoma associated with hepatitis C virus. J Hepatobiliary Pancreat Surg. 2001;8:81–6.CrossRefPubMed
14.
Zurück zum Zitat Sobin LH, Gospodarowicz MK, Wittekind CH, editors. TNM Classification of Malignant Tumours. 7th ed. New York: Wiley-Liss; 2009. Sobin LH, Gospodarowicz MK, Wittekind CH, editors. TNM Classification of Malignant Tumours. 7th ed. New York: Wiley-Liss; 2009.
15.
Zurück zum Zitat The Japan Society of Hepatology. Clinical Practice Guidelines for Hepatocellular Carcinoma 2013 (in Japanese). Tokyo: Kanehara and Co., Ltd; 2013. The Japan Society of Hepatology. Clinical Practice Guidelines for Hepatocellular Carcinoma 2013 (in Japanese). Tokyo: Kanehara and Co., Ltd; 2013.
16.
Zurück zum Zitat Ohba T, Yano T, Yoshida T, Kawano D, Tsukamoto S, Shoji F, et al. Results of a surgical resection of pulmonary metastasis from hepatocellular carcinoma: prognostic impact of the preoperative serum alpha-fetoprotein level. Surg Today. 2012;42:526–31.CrossRefPubMed Ohba T, Yano T, Yoshida T, Kawano D, Tsukamoto S, Shoji F, et al. Results of a surgical resection of pulmonary metastasis from hepatocellular carcinoma: prognostic impact of the preoperative serum alpha-fetoprotein level. Surg Today. 2012;42:526–31.CrossRefPubMed
17.
Zurück zum Zitat Tomimaru Y, Wada H, Eguchi H, Tomokuni A, Hama N, Kawamoto K, et al. Clinical significance of surgical resection of metastatic lymph nodes from hepatocellular carcinoma. Surg Today. 2014. doi:10.1007/s00595-014-1028-8. Tomimaru Y, Wada H, Eguchi H, Tomokuni A, Hama N, Kawamoto K, et al. Clinical significance of surgical resection of metastatic lymph nodes from hepatocellular carcinoma. Surg Today. 2014. doi:10.​1007/​s00595-014-1028-8.
18.
Zurück zum Zitat Nakashima T, Kojiro M. Pathologic characteristics of hepatocellular carcinoma. Semin Liver Dis. 1986;6:259–66.CrossRefPubMed Nakashima T, Kojiro M. Pathologic characteristics of hepatocellular carcinoma. Semin Liver Dis. 1986;6:259–66.CrossRefPubMed
19.
Zurück zum Zitat Kasahara A, Hayashi N, Mochizuki K, Takayanagi M, Yoshioka K, Kakumu S, et al. Risk factors for hepatocellular carcinoma and its incidence after interferon treatment in patients with chronic hepatitis C. Hepatology. 1998;27:1394–402.CrossRefPubMed Kasahara A, Hayashi N, Mochizuki K, Takayanagi M, Yoshioka K, Kakumu S, et al. Risk factors for hepatocellular carcinoma and its incidence after interferon treatment in patients with chronic hepatitis C. Hepatology. 1998;27:1394–402.CrossRefPubMed
20.
Zurück zum Zitat Ikeda K, Saitoh S, Suzuki Y, Kobayashi M, Tsubota A, Fukuda M, et al. Interferon decreases hepatocellular carcinogenesis in patients with cirrhosis caused by the hepatitis B virus: a pilot study. Cancer. 1998;82:827–35.CrossRefPubMed Ikeda K, Saitoh S, Suzuki Y, Kobayashi M, Tsubota A, Fukuda M, et al. Interferon decreases hepatocellular carcinogenesis in patients with cirrhosis caused by the hepatitis B virus: a pilot study. Cancer. 1998;82:827–35.CrossRefPubMed
21.
Zurück zum Zitat Shiratori Y, Shiina S, Imamura M, Kato N, Kanai F, Okudaira T, et al. Characteristic difference of hepatocellular carcinoma between hepatitis B- and C-viral infection in Japan. Hepatology. 1995;22:1027–33.CrossRefPubMed Shiratori Y, Shiina S, Imamura M, Kato N, Kanai F, Okudaira T, et al. Characteristic difference of hepatocellular carcinoma between hepatitis B- and C-viral infection in Japan. Hepatology. 1995;22:1027–33.CrossRefPubMed
22.
Zurück zum Zitat Miyagawa S, Kawasaki S, Makuuchi M. Comparison of the characteristics of hepatocellular carcinoma between hepatitis B and C viral infection: tumor multicentricity in cirrhotic liver with hepatitis C. Hepatology. 1996;24:307–10.CrossRefPubMed Miyagawa S, Kawasaki S, Makuuchi M. Comparison of the characteristics of hepatocellular carcinoma between hepatitis B and C viral infection: tumor multicentricity in cirrhotic liver with hepatitis C. Hepatology. 1996;24:307–10.CrossRefPubMed
23.
Zurück zum Zitat Yamanaka N, Tanaka T, Tanaka W, Yamanaka J, Yasui C, Kuroda N, et al. Correlation of hepatitis virus serologic status with clinicopathologic features in patients undergoing hepatectomy for hepatocellular carcinoma. Cancer. 1997;79:1509–15.CrossRefPubMed Yamanaka N, Tanaka T, Tanaka W, Yamanaka J, Yasui C, Kuroda N, et al. Correlation of hepatitis virus serologic status with clinicopathologic features in patients undergoing hepatectomy for hepatocellular carcinoma. Cancer. 1997;79:1509–15.CrossRefPubMed
24.
Zurück zum Zitat Wu CC, Ho WL, Chen JT, Tang JS, Yeh DC, P’eng FK. Hepatitis viral status in patients undergoing liver resection for hepatocellular carcinoma. Br J Surg. 1999;86:1391–6.CrossRefPubMed Wu CC, Ho WL, Chen JT, Tang JS, Yeh DC, P’eng FK. Hepatitis viral status in patients undergoing liver resection for hepatocellular carcinoma. Br J Surg. 1999;86:1391–6.CrossRefPubMed
25.
Zurück zum Zitat Koike Y, Shiratori Y, Sato S, Obi S, Teratani T, Imamura M, et al. Risk factors for recurring hepatocellular carcinoma differ according to infected hepatitis virus–an analysis of 236 consecutive patients with a single lesion. Hepatology. 2000;32:1216–23.CrossRefPubMed Koike Y, Shiratori Y, Sato S, Obi S, Teratani T, Imamura M, et al. Risk factors for recurring hepatocellular carcinoma differ according to infected hepatitis virus–an analysis of 236 consecutive patients with a single lesion. Hepatology. 2000;32:1216–23.CrossRefPubMed
26.
Zurück zum Zitat Kaibori M, Ishizaki M, Matsui K, Kwon AH. Clinicopathologic characteristics of patients with non-B non-C hepatitis virus hepatocellular carcinoma after hepatectomy. Am J Surg. 2012;204:300–7.CrossRefPubMed Kaibori M, Ishizaki M, Matsui K, Kwon AH. Clinicopathologic characteristics of patients with non-B non-C hepatitis virus hepatocellular carcinoma after hepatectomy. Am J Surg. 2012;204:300–7.CrossRefPubMed
27.
Zurück zum Zitat Toyoda H, Kumada T, Tada T, Niinomi T, Ito T, Kaneoka Y, et al. Prognostic significance of a combination of pre- and post-treatment tumor markers for hepatocellular carcinoma curatively treated with hepatectomy. J Hepatol. 2012;57:1251–7.CrossRefPubMed Toyoda H, Kumada T, Tada T, Niinomi T, Ito T, Kaneoka Y, et al. Prognostic significance of a combination of pre- and post-treatment tumor markers for hepatocellular carcinoma curatively treated with hepatectomy. J Hepatol. 2012;57:1251–7.CrossRefPubMed
28.
Zurück zum Zitat Kiriyama S, Uchiyama K, Ueno M, Ozawa S, Hayami S, Tani M, et al. Triple positive tumor markers for hepatocellular carcinoma are useful predictors of poor survival. Ann Surg. 2011;254:984–91.CrossRefPubMed Kiriyama S, Uchiyama K, Ueno M, Ozawa S, Hayami S, Tani M, et al. Triple positive tumor markers for hepatocellular carcinoma are useful predictors of poor survival. Ann Surg. 2011;254:984–91.CrossRefPubMed
Metadaten
Titel
The tumor marker score is an independent predictor of survival in patients with recurrent hepatocellular carcinoma
verfasst von
Yukiyasu Okamura
Ryo Ashida
Takaaki Ito
Teiichi Sugiura
Keita Mori
Katsuhiko Uesaka
Publikationsdatum
01.12.2015
Verlag
Springer Japan
Erschienen in
Surgery Today / Ausgabe 12/2015
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-014-1102-2

Weitere Artikel der Ausgabe 12/2015

Surgery Today 12/2015 Zur Ausgabe

Leitlinien kompakt für die Allgemeinmedizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Facharzt-Training Allgemeinmedizin

Die ideale Vorbereitung zur anstehenden Prüfung mit den ersten 24 von 100 klinischen Fallbeispielen verschiedener Themenfelder

Mehr erfahren

Update Allgemeinmedizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.