title: Prognostic significance of a combination of pre- and post-treatment tumor markers for hepatocellular carcinoma curatively treated with hepatectomy.
abstract: OBJECTIVE
  Previous studies reported that the combination of three tumor markers for hepatocellular carcinoma (HCC), alpha-fetoprotein (AFP), Lens culinaris agglutinin-reactive AFP (AFP-L3), and des-gamma-carboxy prothrombin (DCP), has the ability to discriminate survival among patients with HCC. In those studies, however, the study population included all patients with various treatment modalities, and tumor markers were measured only before treatment. We investigated the prognostic value of a combination of these tumor markers for HCC, measured before and after treatment, on survival and recurrence in patients treated with hepatectomy.
  
  
  METHODS
  A total of 173 patients who underwent hepatectomy for primary, non-recurrent HCC were analyzed. Tumor characteristics, postoperative survival, and recurrence rates were compared according to the number of elevated tumor markers measured before and after treatment.
  
  
  RESULTS
  The correlation between the number of elevated tumor markers before treatment and tumor size, rate of portal vein invasion, and tumor differentiation, respectively, was stronger than that between the number of elevated tumor markers after treatment. In contrast, the number of elevated tumor markers after treatment displayed an excellent ability to discriminate post-treatment survival and recurrence rates compared to that before treatment, and was an independent factor associated with survival and recurrence in multivariate analysis.
  
  
  CONCLUSIONS
  The combination of tumor markers measured after hepatectomy has a better discriminatory ability for postoperative survival and recurrence in HCC patients treated with hepatectomy in comparison to the combination of tumor markers measured before treatment.
authors: Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan. hmtoyoda@spice.ocn.ne.jp
authors: Hidenori
authors: H
authors: Toyoda
authors: Takashi
authors: T
authors: Kumada
authors: Toshifumi
authors: T
authors: Tada
authors: Takuro
authors: T
authors: Niinomi
authors: Takanori
authors: T
authors: Ito
authors: Yuji
authors: Y
authors: Kaneoka
authors: Atsuyuki
authors: A
authors: Maeda
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000401:mortality / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D037121:Plant Lectins / Q000378:metabolism*; D011379:Prognosis; D011498:Protein Precursors / Q000097:blood*; D011516:Prothrombin; D015996:Survival Rate; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: C097353:AFP protein, human; D015415:Biomarkers; D014408:Biomarkers, Tumor; D037121:Plant Lectins; D011498:Protein Precursors; D000509:alpha-Fetoproteins; C033619:lentil lectin; C008208:acarboxyprothrombin; D011516:Prothrombin