Portal de Periódicos da CAPES

13. Resurrection of serum alphafetoprotein: utility in monitoring treatment response in hepatocellular carcinoma

2018; Elsevier BV; Volume: 8; Linguagem: Inglês

10.1016/j.jceh.2018.06.453

2213-3453

Shashi Bala Paul, Vishnubhatla Sreenivas, Shekhar Singh, Neeti Nadda, Ekta Dhamija, S. Shalimar, Baibaswata Nayak, Subrat Kumar Acharya,

Ferroptosis and cancer prognosis

Background and Aims: To evaluate the role of serial AFP changes in assessment of therapeutic response in AFP secreting Hepatocellular carcinoma (HCC) patients and study the outcome differences between AFP decliners and non-decliners. Methods: In this retrospective study, case records of AFP secreting HCC (AFP ≥ 20 ng/ml) patients subjected to locoregional therapy (transarterial chemoembolization, radiofrequency and acatic acid ablation) were examined. Patients with complete clinical, imaging and follow-up details were included. AFP levels before and one-month post treatment were noted. Serial AFP change was correlated with tumor response [complete (CR), partial (PR) and progressive disease (PD] assessed on one month multiphasic MRI/CT. Best AFP reduction cut off was estimated by receiver operating curves. Clinical, imaging parameters and survival rate were compared amongst those showing post treatment AFP decline and non-decline. Results: AFP secreting HCC patients (n = 126) of mean age 52.8 years, 4:1 male female ratio, Child's A 94, BCLC A/B/C HCC 49/65/12 respectively. After first treatment (one month), 46 patients developed CR, 55 PR and 25 PD. Median AFP level showed 83% reduction in CR, 18% reduction in PR and 16% increase in PD patients. A 30% AFP level reduction could differentiate AFP decliners (CR plus PR) from non-decliners (PD) with 70.3% sensitivity, 68% specificity, AUROC 74% (CI0.64 to 0.85). In AFP decliners and non-decliners, clinical, biochemical and imaging profile were comparable. Survival rate and long term tumor response was better in AFP decliners. Conclusions: Serial AFP change can predict tumor response in AFP producing HCC patients. Early AFP decliners have better survival and tumor outcomes than AFP non-decliners. The authors have none to declare.