Are both PIVKA-II and alpha-fetoprotein necessary in follow-up management after hepatic resection for hepatocellular carcinoma?
OBJECTIVE
The aim of this study was to clarify the need for measuring of PIVKA-II (protein induced by vitamin K absence or antagonist-II) and alpha-fetoprotein as the prognostic indicator for patients after hepatic resection for hepatocellular carcinoma, and as the monitoring modality for early detection of recurrence after hepatic resection.


METHODS
One hundred and thirty-one patients who underwent planned liver resections for hepatocellular carcinoma were studied.


RESULTS
The survival rates in patients positive for preoperative tumor markers were significantly lower than in those in the negative patients. The first modality leading to the diagnosis of recurrence was measurement of alpha-fetoprotein and/or PIVKA-II in 25 cases (55.6%). Almost all patients (96.6%) with positive preoperative alpha-fetoprotein and recurrence had elevated alpha-fetoprotein again when recurrence was found.


CONCLUSIONS
Preoperative PIVKA-II and/or alpha-fetoprotein levels can predict postoperative prognosis. Measurement of these markers is useful in monitoring recurrence. For following up patients with alpha-fetoprotein-producing tumors, alpha-fetoprotein monitoring only is sufficient to detect recurrence.
Koh
T
T
Department of Digestive Surgery, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokohji, Kamigyo-ku, Kyoto 602-8566, Japan. koh@1surg.kpu-m.ac.jp
Taniguchi
H
H
Katoh
H
H
Kunishima
S
S
Yamaguchi
A
A
Yamagishi
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000601:surgery; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011237:Predictive Value of Tests; D011498:Protein Precursors / Q000097:blood*; D011516:Prothrombin; D012189:Retrospective Studies; D015996:Survival Rate; D000509:alpha-Fetoproteins / Q000378:metabolism*
D015415:Biomarkers; D014408:Biomarkers, Tumor; D011498:Protein Precursors; D000509:alpha-Fetoproteins; C008208:acarboxyprothrombin; D011516:Prothrombin