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- Title
Favorable α-fetoprotein decrease as a prognostic surrogate in patients with hepatocellular carcinoma after radiofrequency ablation.
- Authors
Tsai, Ming-Chao; Wang, Jing-Houng; Hung, Chao-Hung; Kee, Kwong-Ming; Yen, Yi-Hao; Lee, Chuan-Mo; Hu, Tsung-Hui; Chen, Chien-Hung; Lu, Sheng-Nan
- Abstract
Background and Aim: To assess the significance of adequate α-fetoprotein decrease in monitoring the treatment effects of radiofrequency ablation (RFA) in hepatocellular carcinoma (HCC) patients. Methods: A total of 72 RFA treatments in 54 HCC patients were analyzed. The favorable α-fetoprotein decrease was defined as the α-fetoprotein half-life of less than 7 days. The efficacy of the ablation response is assessed by standard imaging modality, a computed tomography scan 1 month after RFA. We assessed the correlation between different α-fetoprotein decreases and treatment outcomes by standard imaging modality. Results: Of the 72 therapies, 15 (21%) were favorable α-fetoprotein decreases. Fifty-one (71%) therapies showed concordant results through standard image modality and α-fetoprotein decrease, including 14 (27%) therapies with a complete radiological response and favorable α-fetoprotein decrease, and the remaining 37 (73%) therapies with an incomplete radiological response and unfavorable α-fetoprotein decrease. The accuracy was 70.8% by using α-fetoprotein decrease in the detection treatment response based on a complete radiological response. Among the 34 therapies with a complete radiological response, 14 therapies with a favorable α-fetoprotein decrease had a better disease-free survival curve than 20 therapies with an unfavorable α-fetoprotein decrease ( P = 0.003). Only one case had a favorable α-fetoprotein decrease, but incomplete radiological response, with massive necrosis, with the exception of a small residual tumor. Conclusions: A favorable α-fetoprotein decrease has better predictive power for disease-free survival than for an unfavorable α-fetoprotein decrease. HCC patients after RFA with an unfavorable α-fetoprotein decrease should be considered to have undergone incomplete treatment, despite the complete response by standard image modality post-RFA.
- Subjects
RADIO frequency; ABLATION techniques; LIVER cancer patients; ALPHA fetoproteins; RADIOLOGY; RETROSPECTIVE studies
- Publication
Journal of Gastroenterology & Hepatology, 2010, Vol 25, Issue 3, p605
- ISSN
0815-9319
- Publication type
Article
- DOI
10.1111/j.1440-1746.2009.06115.x