title: Can we predict the prognosis of resectable hepatoblastoma from serum alpha-fetoprotein response during preoperative chemotherapy?
abstract: OBJECTIVE
  The objective of this study was to clarify whether the alpha-fetoprotein (AFP) reduction rate during preoperative chemotherapy represents a prognostic factor for hepatoblastoma.
  
  
  METHODS
  We divided 14 hepatoblastoma patients who underwent preoperative chemotherapy and curative resection into Group A (no recurrence; n = 10) and Group B (recurrence; n = 4). We then compared AFP levels before and after preoperative chemotherapy between groups.
  
  
  RESULTS
  Mean AFP level after completing the first cycle of chemotherapy was reduced to 7.28 % (range 1.2-36.8 %) in Group A and 17.05 % (range 12.0-20.5 %) in Group B (p < 0.05). Mean AFP after total preoperative chemotherapy was reduced to 1.42 % (range 0.07-8.5 %) in Group A and 7.55 % (range 3.4-12.4 %) in Group B (p < 0.02). Eight patients in whom AFP levels decreased >1 log after the first cycle of preoperative chemotherapy survived without recurrence.
  
  
  CONCLUSIONS
  A large, early decrease in AFP level during preoperative chemotherapy may offer a strong indicator of survival. Patients in whom AFP levels do not decrease easily during preoperative chemotherapy may have increased risk of recurrence and should be followed very closely.
authors.affiliation: Department of Pediatric Surgery, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660, Japan. fukuzawa1203@yahoo.co.jp
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Fukuzawa
authors.forename: Naoto
authors.initials: N
authors.lastname: Urushihara
authors.forename: Koji
authors.initials: K
authors.lastname: Fukumoto
authors.forename: Maki
authors.initials: M
authors.lastname: Mitsunaga
authors.forename: Kentaro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Takeshi
authors.initials: T
authors.lastname: Aoba
authors.forename: Shinya
authors.initials: S
authors.lastname: Yamoto
authors.forename: Hiromu
authors.initials: H
authors.lastname: Miyake
authors.forename: Shiro
authors.initials: S
authors.lastname: Hasegawa
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D018197:Hepatoblastoma / Q000097:blood* / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008113:Liver Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000601:surgery; D008297:Male; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods*; D011379:Prognosis; D000509:alpha-Fetoproteins / Q000378:metabolism*
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins