Abstract
Purpose
The study aimed to investigate the prognostic role of the preoperative carbohydrate antigen 19-9 (CA19-9) level in alpha-fetoprotein (AFP)-negative (AFP < 25 ng/ml) hepatocellular carcinoma (HCC) patients.
Methods
From December 2004 to December 2013, 750 patients diagnosed with AFP-negative HCC following curative resection were enrolled. Both univariate and multivariate analyses were performed to clarify the prognostic factors for overall survival (OS) and disease-free survival (DFS).
Results
The optimal cutoff point for preoperative CA19-9 was 32.6 U/ml, and the value of the area under the curve was 0.640. The 1-, 3-, and 5-year OS rates were 88.4, 72.2, and 57.0%, respectively, for the CA19-9 > 32.6 U/ml group and 97.0, 83.3, and 79.9%, respectively, for the CA19-9 ≤ 32.6 U/ml group (P < 0.001). The 1-, 3-, and 5-year DFS rates were 71.8, 47.7, and 34.8%, respectively, for the CA19-9 > 32.6 U/ml group and 80.8, 63.6, and 55.5%, respectively, for the CA19-9 ≤ 32.6 U/ml group (P < 0.001). The multivariate analysis showed that CA19-9 > 32.6 U/ml was one of the most significant unfavorable predictors of OS and DFS (P < 0.001 for both).
Conclusions
Preoperative CA19-9 > 32.6 U/ml is a predictor of dismal prognosis and can be employed as a prognostic marker for patient selection in AFP-negative HCC management.
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Acknowledgments
This study was supported by grants from the National Natural Science Foundation of China (No. 81172037/H1606) and the Guangdong Province Science and Technology Project of China (No. 2013B021800159). We are also grateful to and thank all the patients who participated in this study.
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Guo RP and Lu LH designed the study; Lu LH and Zhan YF collected and analyzed the data, performed the statistical analysis, and wrote the manuscript (Lu LH and Zhan YF made equal contributions); and Guo RP, Wei W, and Shi M analyzed the data and contributed to the discussion and revision.
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This study was supported by grants from the Guangdong Province Science and Technology Project of China (No. 2013B021800159).
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The authors declare that they have no conflicts of interest.
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Lu, LH., Zhang, YF., Wei, W. et al. Preoperative Carbohydrate Antigen 19-9: Its Neglected Role in Alpha-Fetoprotein-Negative Hepatocellular Carcinoma Patients. J Gastrointest Surg 21, 2025–2032 (2017). https://doi.org/10.1007/s11605-017-3528-5
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DOI: https://doi.org/10.1007/s11605-017-3528-5