Abstract 2898: Prognostic value of postoperative alpha-fetoprotein level on recurrence after curative resection for hepatocellular carcinoma

Abstract Background: The high incidence of recurrence after curative resection is a major challenge in hepatocellular carcinoma (HCC) treatment. Although serum alpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) are well known as tumor markers of HCC, the clinical usefulness for early detection of HCC recurrence remains controversial. In this retrospective study, we evaluated the clinical value of AFP and DCP levels in predicting HCC recurrence after curative resection, with a focus on the time course as surveillance tools. Methods: A total of 165 consecutive HCC patients who had undergone curative hepatectomy at the National Cancer Center Hospital East from 2005 to 2007 and whose serum AFP and DCP had been measured before and after hepatectomy were included in this study. The minimum postoperative levels within a 4-month period were used for analysis. In this study, the cut-off levels for AFP and DCP were set to 10 ng/ml and 40 mAU/ml, respectively. Results: Until the end of follow-up, tumor recurrence was identified in 114 patients (69.1%). Among the patients with a positive level of AFP before operation, the number of patients whose AFP level did not change from positive to negative after operation in the group with recurrence exceeded that in the group without recurrence (48/60, 80.0% vs. 4/23, 17.4%), and the difference was significant (P < 0.001). In contrast, there was no significant difference between two groups in DCP (14/72, 19.4% vs. 2/29, 6.9%; P=0.118). Minimum postoperative AFP level was found to be a significant independent risk factor for recurrence by univariate and multivariate analysis (P < 0.001). There was no statistically significant correlation between AFP level and grade of hepatitis activity (P = 0.599). Conclusions: Postoperative AFP level is a useful predictor of recurrence after curative hepatectomy. A positive level of AFP after operation might suggest a site of residual viable cancer. The need for effective adjuvant therapy and close follow-up is suggested in patients with a positive postoperative AFP level. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 2898.