Post-ablation des-gamma-carboxy prothrombin level predicts prognosis in hepatitis B-related hepatocellular carcinoma.
OBJECTIVE
We investigated whether pre- or post-ablation serum alpha-foetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) levels can predict prognosis in patients with curative radiofrequency ablation (RFA) for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).


METHODS
We retrospectively analysed 412 patients with HBV-related single HCC treated with percutaneous RFA between January 2004 and December 2013. AFP and DCP levels were measured before (pre-ablation) and 1 month after treatment (post-ablation). We assessed predictive factors for overall and recurrence-free survival.


RESULTS
On univariate analysis, Child-Pugh score, Model for End-Stage Liver Disease (MELD) score, platelet count, tumour size, Barcelona Clinic Liver Cancer (BCLC) stage, and pre- and post-ablation DCP were significant for overall survival; and age, Child-Pugh score, MELD score, platelet count, tumour size, Cancer of the Liver Italian Program (CLIP) score, BCLC stage, and pre- and post-ablation AFP and DCP were significant for recurrence-free survival. Multivariate analysis revealed significant differences in overall survival by MELD score and tumour size and in recurrence-free survival by BCLC stage. Among the tumour markers, post-ablation DCP was an independent prognostic factor for overall and recurrence-free survival [hazard ratio (HR), 3.438; 95% confidence interval (CI), 1.331-8.877; P = 0.011 and HR, 4.934; 95% CI, 2.761-8.816; P < 0.001 respectively]. Post-ablation AFP was associated with recurrence-free survival (HR, 1.995; 95% CI, 1.476-2.697; P < 0.001) but not overall survival.


CONCLUSIONS
In patients with HBV-related HCC, post-ablation serum DCP is a useful biomarker for predicting survival and recurrence after curative RFA.
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Sunyoung
S
Lee
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Hyunchul
H
Rhim
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Young-sun
YS
Kim
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Tae Wook
TW
Kang
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Kyoung Doo
KD
Song
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000401:mortality / Q000601:surgery* / Q000821:virology; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D006509:Hepatitis B / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000097:blood* / Q000401:mortality / Q000601:surgery* / Q000821:virology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011498:Protein Precursors / Q000097:blood*; D011516:Prothrombin; D056910:Republic of Korea; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D000509:alpha-Fetoproteins / Q000032:analysis
C097353:AFP protein, human; D015415:Biomarkers; D014408:Biomarkers, Tumor; D011498:Protein Precursors; D000509:alpha-Fetoproteins; C008208:acarboxyprothrombin; D011516:Prothrombin
des-gamma-carboxy prothrombin; hepatitis B virus; hepatocellular carcinoma; radiofrequency ablation