title: Half-life of serum alpha-fetoprotein: an early prognostic index of recurrence and survival after hepatic resection for hepatocellular carcinoma.
abstract: OBJECTIVE
  To explore the prognostic value of the postsurgical half-life (HL) of serum alpha-fetoprotein (AFP).
  
  
  BACKGROUND
  There is still a paucity of early surrogate indicators of clinical endpoints after liver resection of hepatocellular carcinoma (HCC).
  
  
  METHODS
  The analysis was based on cohorts of 225 (exploration set) and 117 (validation set) treatment-naïve HCC patients undergoing curative liver resection. We defined 3 categories of AFP HL: early complete resolution of AFP, normal HL, and prolonged HL if the HL exceeded 7 days. Overall, probabilities of recurrence and survival were estimated and compared across the AFP HL categories.
  
  
  RESULTS
  In the exploration cohort, 48 patients (21.3%) achieved early AFP complete resolution, 116 (51.6%) had normal HL, and 61 (27.1%) had prolonged HL. Long AFP HL was significantly associated with early postoperative recurrence (P < 0.001), as was microvascular invasion. Early recurrence within 2 years of resection was observed in 59% of the patients with prolonged AFP HL compared with only 29.3% of those with normal AFP HL (P < 0.001). A log-rank test followed by multivariate Cox analysis identified an independent function of prolonged AFP HL in predicting shorter recurrence-free survival and overall survival time after HCC resection (hazard ratios, 2.81 and 3.58; P < 0.001). When AFP HL analysis was applied to the validation cohort, the association between prolonged AFP HL and survival endpoints (hazard ratio, 11.63 and 16.39; P < 0.001) was confirmed.
authors.affiliation: Departments of Gastroenterology, Asan Cancer Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. s5854@medimail.co.kr
authors.forename: Ju Hyun
authors.initials: JH
authors.lastname: Shim
authors.forename: Seungbong
authors.initials: S
authors.lastname: Han
authors.forename: Young-Joo
authors.initials: YJ
authors.lastname: Lee
authors.forename: Sung-Gyu
authors.initials: SG
authors.lastname: Lee
authors.forename: Kang Mo
authors.initials: KM
authors.lastname: Kim
authors.forename: Young-Suk
authors.initials: YS
authors.lastname: Lim
authors.forename: Young-Hwa
authors.initials: YH
authors.lastname: Chung
authors.forename: Yung Sang
authors.initials: YS
authors.lastname: Lee
authors.forename: Han Chu
authors.initials: HC
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000401:mortality* / Q000601:surgery; D005260:Female; D006207:Half-Life; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000401:mortality* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood* / Q000175:diagnosis; D011379:Prognosis; D015996:Survival Rate; D055815:Young Adult; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins