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Assessment of treatment outcomes based on tumor marker trends in patients with recurrent hepatocellular carcinoma undergoing trans-catheter arterial chemo-embolization

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Abstract

Purpose

The aim of the present study was to evaluate whether serum alpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) trends might be correlated with overall survival rates in patients with recurrent hepatocellular carcinoma (HCC) undergoing trans-catheter arterial chemo-embolization (TACE).

Methods

We performed a retrospective cohort study of 142 patients with recurrent HCC who were treated by TACE at our hospital from April 1990 to December 2011. Patients were divided into three groups, as follows, according to the trends of the two tumor markers AFP and DCP: the low group, comprising patients with tumor marker levels below the cutoff values (AFP 100 ng/mL and DCP 100 mAU/mL) both pre- and post-TACE; the decreased group, comprising patients with elevated tumor marker levels pre-TACE in whom the levels decreased post-TACE; and the elevated group, comprising patients with elevated tumor marker levels post-TACE.

Result

Analysis using a Cox proportional hazards model identified the DCP trend (elevated group vs. low group, hazard ratio 8.47, 95 % confidence interval 4.53–15.84, p < 0.0001), but not the AFP trend, as an independent prognostic factor for survival. While the AFP trend was correlated only with the overall response rate assessed using the modified Response Evaluation Criteria in Solid Tumors (mRECIST; p = 0.041), the DCP trend was strongly associated with both the overall response rate (p = 0.009) and the disease control rate (p = 0.004).

Conclusion

The DCP trend might be useful for assessing treatment outcomes after TACE in patients with recurrent HCC.

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Acknowledgments

We would like to thank Dr. Teruomi Tsukahara, Department of Preventive Medicine and Public Health, Shinshu University School of Medicine, for his assistance in the statistical analysis.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Surgery, Okaya Municipal Hospital, 4-11-33 Hon-machi, Okaya, 394-8512, Japan

    Takuma Arai

  2. First Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan

    Akira Kobayashi, Takahide Yokoyama, Akira Shimizu, Hiroaki Motoyama, Norihiko Furusawa, Tsuyoshi Notake, Noriyuki Kitagawa, Hiroshi Sakai & Shin-ichi Miyagawa

  3. Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan

    Ayumi Ohya, Masaaki Takahashi & Masumi Kadoya

  4. Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan

    Hiroshi Imamura

Authors
  1. Takuma Arai
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  2. Akira Kobayashi
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  3. Ayumi Ohya
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  4. Masaaki Takahashi
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  14. Shin-ichi Miyagawa
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Correspondence to Akira Kobayashi.

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Arai, T., Kobayashi, A., Ohya, A. et al. Assessment of treatment outcomes based on tumor marker trends in patients with recurrent hepatocellular carcinoma undergoing trans-catheter arterial chemo-embolization. Int J Clin Oncol 19, 871–879 (2014). https://doi.org/10.1007/s10147-013-0634-6

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  • DOI: https://doi.org/10.1007/s10147-013-0634-6

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