Risk stratification of patients with hepatocellular carcinoma undergoing trans arterial chemoembolization using an alpha-fetoprotein model

Abstract Background Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide. There are multiple factors that could affect the malignancy and progression of HCC including tumor number, size, and macrovascular invasion. The alpha-fetoprotein (AFP) model was validated as a predictor fo...

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Autores principales:	Mohamed Eltabbakh, Heba M. Abdella, Safaa Askar, Mohamed A. Abuhashima, Mohamed K. Shaker
Formato:	article
Lenguaje:	EN
Publicado:	SpringerOpen 2021
Materias:	Hepatocellular carcinoma Egypt Alpha-fetoprotein model Trans arterial chemoembolization Response Recurrence Surgery RD1-811 Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/ea657700c85e4e9385f6027bd8fa1401
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spelling	oai:doaj.org-article:ea657700c85e4e9385f6027bd8fa14012021-11-28T12:22:00ZRisk stratification of patients with hepatocellular carcinoma undergoing trans arterial chemoembolization using an alpha-fetoprotein model10.1186/s43066-021-00155-y2090-6226https://doaj.org/article/ea657700c85e4e9385f6027bd8fa14012021-11-01T00:00:00Zhttps://doi.org/10.1186/s43066-021-00155-yhttps://doaj.org/toc/2090-6226Abstract Background Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide. There are multiple factors that could affect the malignancy and progression of HCC including tumor number, size, and macrovascular invasion. The alpha-fetoprotein (AFP) model was validated as a predictor for HCC recurrence post-liver transplantation, especially in France. However, the AFP model has not been studied on patients with HCC undergoing locoregional treatment. This study aimed to assess the prognostic value of the AFP model in patients with HCC undergoing trans arterial chemoembolization (TACE). This cohort study was conducted at Ain Shams University Hospitals, Cairo, Egypt. We included all newly diagnosed patients with HCC who were fit for TACE from January 2012 to January 2017. The AFP model was calculated for each patient before TACE. Subsequently, we classified them into low- and high-risk groups for TACE. The patients were followed up by AFP level and triphasic spiral CT performed 1 month after TACE to evaluate the response then at 4 months and 7 months post TACE to evaluate the local and distant recurrence. Results One hundred and thirty-two patients were included in the study. Complete response (CR) was achieved nonsignificantly at a higher percentage in the low-risk group in comparison with the high-risk group. One- and three-year recurrence-free survivals (RFS) were longer in the low-risk group in comparison with the high-risk group (50% and 24.1% vs. 29.1% and 16.2%, respectively). One- and three-year overall survival (OS) rates were 97% and 37.3% in the low-risk group vs. 98.1% and 11.6% in the high-risk group, respectively, without statistical significance. On classifying patients with AFP levels < 100 IU/mL into low- and high-risk patients, CR was achieved in a significantly higher percentage in the low-risk group in comparison with the high-risk group(P < 0.05). Recurrence occurred nonsignificantly in a less percentage in low than high-risk group. The median OS was significantly higher in the low-risk group in comparison with that in the high-risk group (18 vs. 16 months respectively) (P < 0.01). Conclusion The AFP model may have a prognostic value for patients with HCC undergoing TACE especially in patients with an AFP level < 100 IU/mL.Mohamed EltabbakhHeba M. AbdellaSafaa AskarMohamed A. AbuhashimaMohamed K. ShakerSpringerOpenarticleHepatocellular carcinomaEgyptAlpha-fetoprotein modelTrans arterial chemoembolizationResponseRecurrenceSurgeryRD1-811Diseases of the digestive system. GastroenterologyRC799-869ENEgyptian Liver Journal, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Hepatocellular carcinoma Egypt Alpha-fetoprotein model Trans arterial chemoembolization Response Recurrence Surgery RD1-811 Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	Hepatocellular carcinoma Egypt Alpha-fetoprotein model Trans arterial chemoembolization Response Recurrence Surgery RD1-811 Diseases of the digestive system. Gastroenterology RC799-869 Mohamed Eltabbakh Heba M. Abdella Safaa Askar Mohamed A. Abuhashima Mohamed K. Shaker Risk stratification of patients with hepatocellular carcinoma undergoing trans arterial chemoembolization using an alpha-fetoprotein model
description	Abstract Background Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide. There are multiple factors that could affect the malignancy and progression of HCC including tumor number, size, and macrovascular invasion. The alpha-fetoprotein (AFP) model was validated as a predictor for HCC recurrence post-liver transplantation, especially in France. However, the AFP model has not been studied on patients with HCC undergoing locoregional treatment. This study aimed to assess the prognostic value of the AFP model in patients with HCC undergoing trans arterial chemoembolization (TACE). This cohort study was conducted at Ain Shams University Hospitals, Cairo, Egypt. We included all newly diagnosed patients with HCC who were fit for TACE from January 2012 to January 2017. The AFP model was calculated for each patient before TACE. Subsequently, we classified them into low- and high-risk groups for TACE. The patients were followed up by AFP level and triphasic spiral CT performed 1 month after TACE to evaluate the response then at 4 months and 7 months post TACE to evaluate the local and distant recurrence. Results One hundred and thirty-two patients were included in the study. Complete response (CR) was achieved nonsignificantly at a higher percentage in the low-risk group in comparison with the high-risk group. One- and three-year recurrence-free survivals (RFS) were longer in the low-risk group in comparison with the high-risk group (50% and 24.1% vs. 29.1% and 16.2%, respectively). One- and three-year overall survival (OS) rates were 97% and 37.3% in the low-risk group vs. 98.1% and 11.6% in the high-risk group, respectively, without statistical significance. On classifying patients with AFP levels < 100 IU/mL into low- and high-risk patients, CR was achieved in a significantly higher percentage in the low-risk group in comparison with the high-risk group(P < 0.05). Recurrence occurred nonsignificantly in a less percentage in low than high-risk group. The median OS was significantly higher in the low-risk group in comparison with that in the high-risk group (18 vs. 16 months respectively) (P < 0.01). Conclusion The AFP model may have a prognostic value for patients with HCC undergoing TACE especially in patients with an AFP level < 100 IU/mL.
format	article
author	Mohamed Eltabbakh Heba M. Abdella Safaa Askar Mohamed A. Abuhashima Mohamed K. Shaker
author_facet	Mohamed Eltabbakh Heba M. Abdella Safaa Askar Mohamed A. Abuhashima Mohamed K. Shaker
author_sort	Mohamed Eltabbakh
title	Risk stratification of patients with hepatocellular carcinoma undergoing trans arterial chemoembolization using an alpha-fetoprotein model
title_short	Risk stratification of patients with hepatocellular carcinoma undergoing trans arterial chemoembolization using an alpha-fetoprotein model
title_full	Risk stratification of patients with hepatocellular carcinoma undergoing trans arterial chemoembolization using an alpha-fetoprotein model
title_fullStr	Risk stratification of patients with hepatocellular carcinoma undergoing trans arterial chemoembolization using an alpha-fetoprotein model
title_full_unstemmed	Risk stratification of patients with hepatocellular carcinoma undergoing trans arterial chemoembolization using an alpha-fetoprotein model
title_sort	risk stratification of patients with hepatocellular carcinoma undergoing trans arterial chemoembolization using an alpha-fetoprotein model
publisher	SpringerOpen
publishDate	2021
url	https://doaj.org/article/ea657700c85e4e9385f6027bd8fa1401
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Risk stratification of patients with hepatocellular carcinoma undergoing trans arterial chemoembolization using an alpha-fetoprotein model

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