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Double- and Triple-Positive Tumor Markers Predict Early Recurrence and Poor Survival in Patients with Hepatocellular Carcinoma within the Milan Criteria and Child-Pugh Class A

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

The prognostic implications of the expression patterns of three tumor markers, alpha-fetoprotein (AFP), the Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3) and des-γ-carboxy prothrombin (DCP), have been evaluated in patients with hepatocellular carcinoma (HCC). From January 1994 to December 2014, 1182 consecutive patients underwent hepatic resection and surgical microwave ablation for HCC at our institution. This study analyzed 475 patients within the Milan criteria and Child–Pugh class A. Cumulative overall survival (OS) and disease-free survival (DFS) rates were analyzed relative to the number of positive tumor markers. OS and DFS at 5 years postoperatively were 85.3 and 44.2% in triple-negative patients, 79.4 and 48.0% in single-positive patients, 56.2 and 32.9% in double-positive patients, and 61.7 and 35.7% in triple-positive patients with statistical significance. OS in triple-negative or single-positive patients was 85.3%, and that in all double- or triple-positive patients was 58.0% (P < 0.0001); DFS at 5 years postoperatively in these two groups was 45.9 and 34.0%, respectively (P < 0.0013). Both double- and triple-positive tumor markers are associated with early recurrence and poor survival in HCC patients within the Milan criteria and Child–Pugh class A.

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Authors and Affiliations

  1. Department of Hepato-Biliary-Pancreatic Surgery, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama Chuo-ku, Fukuoka, 810-8563, Japan

    Tomoki Ryu, Yuko Takami, Yoshiyuki Wada, Masaki Tateishi, Hajime Matsushima, Kazuhiro Mikagi & Hideki Saitsu

Authors
  1. Tomoki Ryu
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  2. Yuko Takami
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  3. Yoshiyuki Wada
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  4. Masaki Tateishi
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  5. Hajime Matsushima
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  6. Kazuhiro Mikagi
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  7. Hideki Saitsu
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Contributions

Study conception and design: Ryu, Takami, and Saitsu Acquisition of data: Ryu, Wada, Tateishi, Matsushima, and Mikagi Analysis and interpretation of data: Ryu, Takami, and Saitsu Drafting of manuscript: Ryu Critical revision: Saitsu

Corresponding author

Correspondence to Tomoki Ryu.

Ethics declarations

This retrospective study was conducted in accordance with the Declaration of Helsinki and the ethical guidelines for clinical studies of the Ministry of Health, Labor and Welfare in Japan. The study protocol was approved by the Ethics Committee on Clinical Investigations of Kyushu Medical Center.

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The authors declare that they have no conflicts of interest.

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Ryu, T., Takami, Y., Wada, Y. et al. Double- and Triple-Positive Tumor Markers Predict Early Recurrence and Poor Survival in Patients with Hepatocellular Carcinoma within the Milan Criteria and Child-Pugh Class A. J Gastrointest Surg 21, 957–966 (2017). https://doi.org/10.1007/s11605-017-3394-1

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  • DOI: https://doi.org/10.1007/s11605-017-3394-1

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