title: A case-control study of correlation between preoperative serum AFP and recurrence of hepatocellular carcinoma after curative hepatectomy.
abstract: OBJECTIVE
  The prognostic impact of serum alpha-fetoprotein (AFP) on patients with hepatocellular carcinoma (HCC) undergoing curative resection remains unclear. We conducted a case-control study to investigate it.
  
  
  METHODS
  A total of 196 HCC patients with negative preoperative AFP were admitted and treated by curative liver resection. During the same period, 196 patients with positive preoperative AFP were enrolled to match the TN M stages, Child-Pugh score and HBs-Ag status of the AFP-negative patients. Time to recurrence (TTR) and overall survival (OS) were prospectively studied.
  
  
  RESULTS
  Through a median follow-up duration of 5.25 years, we found that the median TTR of patients with negative preoperative AFP was significantly longer than those with positive AFP (17.3 vs. 12.8 months, p=0.001). The median TTRs of AFP-negative and positive patients were 22.1 and 21.0 months (p=0.266), 145 and 7.4 months (p=0.005) and 3.7 and 2.9 months (p=0.197) in TNM stages I, II and IIIa, respectively. The median TTRs of TNM stage II patients with :≤20, 20-400, 400-1000 and >1000 ng/mL preoperative AFP concentration were 14.5, 13.7, 10.7 and 9.6 months (p=0.092), respectively.
  
  
  CONCLUSIONS
  Preoperative AFP level is an independent prognostic factor affecting postoperative recurrence in HCC patients and correlated with the TTR of TNM II.
authors.affiliation: The Fourth Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Xia
authors.forename: Zhen-Lin
authors.initials: ZL
authors.lastname: Yan
authors.forename: Tao
authors.initials: T
authors.lastname: Xi
authors.forename: Kui
authors.initials: K
authors.lastname: Wang
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.forename: Le-Hua
authors.initials: LH
authors.lastname: Shi
authors.forename: Meng-Chao
authors.initials: MC
authors.lastname: Wu
authors.forename: Feng
authors.initials: F
authors.lastname: Shen
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: C097353:AFP protein, human; D000509:alpha-Fetoproteins