Fucosylated fraction of alpha-fetoprotein as a predictor of prognosis in patients with hepatocellular carcinoma after curative treatment.
OBJECTIVE
The aim of this study was to evaluate the clinical usefulness of measuring the Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein (AFP-L3) for prognostic predictor in patients with hepatocellular carcinoma (HCC).


METHODS
A total of 477 HCC patients who underwent percutaneous ablative therapy or hepatectomy were enrolled. Overall survival and recurrence-free survival were respectively evaluated retrospectively and prospectively. Multivariate analyses of clinical prognostic factors were performed by Cox's stepwise proportional hazard model.


RESULTS
AFP-L3 status was a statistically significant independent prognostic factor of long-term survival (P = 0.013) and recurrence-free survival (P = 0.006) in patients who underwent percutaneous ablative therapy. In contrast, AFP-L3 did not affect prognosis in patients who underwent hepatectomy.


CONCLUSIONS
AFP-L3 had different impacts on prognosis in patients with HCC who underwent percutaneous ablative therapy and hepatectomy. Our results suggest that AFP-L3 positivity (>or=15%) might be a promising indicator for choosing therapeutic modalities in HCC patients.
Tamura
Yasushi
Y
Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata, Japan.
Igarashi
Masato
M
Suda
Takeshi
T
Wakai
Toshifumi
T
Shirai
Yoshio
Y
Umemura
Takeji
T
Tanaka
Eiji
E
Kakizaki
Satoru
S
Takagi
Hitoshi
H
Hiasa
Yoichi
Y
Onji
Morikazu
M
Aoyagi
Yutaka
Y
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D014408:Biomarkers, Tumor / Q000097:blood / Q000378:metabolism*; D001707:Biopsy, Needle; D006528:Carcinoma, Hepatocellular / Q000378:metabolism / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D018572:Disease-Free Survival; D004724:Endoscopy / Q000379:methods / Q000401:mortality; D005260:Female; D006498:Hepatectomy / Q000379:methods / Q000401:mortality; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D011336:Probability; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D000509:alpha-Fetoproteins / Q000378:metabolism*
D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins