title: Prediction of recurrence of hepatocellular carcinoma after curative hepatectomy using preoperative Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein.
abstract: OBJECTIVE
  Lens culinaris agglutinin A-reactive fraction of α-fetoprotein (AFP-L3) status has been reported to be an independent prognostic factor in patients with hepatocellular carcinoma (HCC). In this study, we evaluated the clinical usefulness of measuring preoperative AFP-L3 to predict the recurrence and prognosis of HCC after curative hepatectomy.
  
  
  METHODS
  One hundred and forty-two HCC patients who underwent curative hepatectomy were examined for the correlation between preoperative tumor marker, including AFP, des-γ-carboxy prothrombin (DCP) and AFP-L3, and clinicopathological variables. The prognostic factors of disease-free survival rates and overall survival rates were also determined using clinicopathological variables including these three tumor markers.
  
  
  RESULTS
  There were similar tendencies in the relationship between these three markers and malignant behaviors including lower grade tumor differentiation or vascular invasion. In multivariate analysis, increased AFP-L3 value (P = 0.019) was found to be an independent prognostic factor of disease-free survival after curative hepatectomy. In addition, elevated DCP (P = 0.013) and AFP-L3 values (P = 0.012) were found to be independent prognostic factors. Furthermore, the preoperative AFP-L3 value in the patients with early recurrence (within 1 year after hepatectomy) was significantly higher than that in those without early recurrence (26.9 ± 19.5 % vs 14.2 ± 19.8 %, P = 0.047).
  
  
  CONCLUSIONS
  Preoperative AFP-L3 value was strongly correlated to disease-free and overall survival rate and the timing of recurrence, so it appears that it would be useful to predict the recurrence and prognosis of HCC after curative hepatectomy.
authors.affiliation: Department of Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Saito
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Shimada
authors.forename: Tohru
authors.initials: T
authors.lastname: Utsunomiya
authors.forename: Yuji
authors.initials: Y
authors.lastname: Morine
authors.forename: Satoru
authors.initials: S
authors.lastname: Imura
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ikemoto
authors.forename: Hiroki
authors.initials: H
authors.lastname: Mori
authors.forename: Jun
authors.initials: J
authors.lastname: Hanaoka
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Yamada
authors.forename: Michihito
authors.initials: M
authors.lastname: Asanoma