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Prognostic relevance of oncological serum biomarkers in liver cancer patients undergoing transarterial chemoembolization therapy

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Tumor Biology

Abstract

As transarterial chemoembolization (TACE) therapy is an effective locoregional treatment for patients with advanced liver cancer, prognostic biomarkers are highly needed for pretherapeutic stratification of patients to TACE therapy. Sera of 50 prospectively and consecutively included patients with hepatocellular carcinoma (HCC) undergoing TACE were taken before and 24 h after TACE application. Levels of liver-specific, tumor-related, and cell death biomarkers were analyzed and correlated with overall patient survival. The study was particularly focused on patients treated by TACE with palliative intention (N = 38). Sixteen of 38 patients died within 1 year after TACE, 22 were still alive. In univariate analysis, high levels of cytokeratin 19-fragments (CYFRA 21-1), alpha fetoprotein (AFP), and low choline esterase (CHE) levels measured before and 24 h after TACE were correlated with unfavorable outcome. Further high pretherapeutic lactate dehydrogenase (LDH), aspartate-aminotransferase, and bilirubin levels as well as high 24 h C-reactive protein values were associated with poor survival. In multivariate analysis of clinical and only pretherapeutic biomarkers, AFP, CHE, and LDH showed to be independent prognostic parameters. When additionally 24 h values were included, CHE (24 h) and AFP (24 h) were the strongest independent prognostic biomarkers with a slightly higher prognostic power (Akaike’s information criterion 90.3 vs. 92.7). The combination of AFP, CHE, and LDH enables efficient pretherapeutic stratification of HCC patients in advanced tumor stage for TACE therapy.

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Acknowledgments

We are very grateful for the committed support of Prof. Jüngst who died recently. We thank Dr. Waggershauser from the Institute of Radiology of the University Hospital Munich for the excellent technical assistance in the evaluation of CT and MRI imaging.

The work is part of the doctoral thesis of Nikolaus Kohles.

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Authors and Affiliations

  1. Institute of Clinical Chemistry, University-Hospital Munich-Grosshadern, Munich, Germany

    Nikolaus Kohles, Dorothea Nagel, Jürgen Durner, Petra Stieber & Stefan Holdenrieder

  2. Medical Clinic II, University-Hospital Munich-Grosshadern, Munich, Germany

    Dietrich Jüngst

  3. Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, Sigmund-Freud Str. 15, 53127, Bonn, Germany

    Stefan Holdenrieder

Authors
  1. Nikolaus Kohles
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  2. Dorothea Nagel
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  3. Dietrich Jüngst
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  5. Petra Stieber
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Correspondence to Stefan Holdenrieder.

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Kohles, N., Nagel, D., Jüngst, D. et al. Prognostic relevance of oncological serum biomarkers in liver cancer patients undergoing transarterial chemoembolization therapy. Tumor Biol. 33, 33–40 (2012). https://doi.org/10.1007/s13277-011-0237-7

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  • DOI: https://doi.org/10.1007/s13277-011-0237-7

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