Prognostic implications of preoperative, postoperative, and dynamic changes of alpha-fetoprotein and des-gamma (γ)-carboxy prothrombin expression pattern for hepatocellular carcinoma after hepatic resection: a multicenter observational study

Shi-Chuan Tang ^1,2, Ye-Ye Wu ³, Zhi-Wen Lin ²

⁰Department of Hepatopancreatobiliary Surgery, The First Clinical Medical College of Fujian Medical University and First Affiliated Hospital of Fujian Medical University, Fuzhou, China.

Frontiers in Oncology +

|

June 21, 2024

View abstract on PubMed

Summary

Postoperative alpha-fetoprotein (AFP) and des-gamma (γ)-carboxy prothrombin (DCP) levels, not preoperative ones, predict hepatocellular carcinoma (HCC) recurrence and survival after surgery. A decrease in these tumor markers post-surgery indicates a better prognosis.

Area Of Science

Hepatocellular Carcinoma Research
Surgical Oncology
Biomarker Discovery

Background

The prognostic value of pre- and post-operative alpha-fetoprotein (AFP) and des-gamma (γ)-carboxy prothrombin (DCP) expression patterns in hepatocellular carcinoma (HCC) following hepatic resection remains unclear.
Dynamic changes in these tumor markers are crucial for predicting surgical outcomes.

Purpose Of The Study

To elucidate the utility of pre- and post-operative AFP and DCP expression patterns and their dynamic changes as predictors of outcomes after hepatic resection for HCC.
To assess the prognostic significance of AFP-DCP expression patterns and their postoperative modifications.

Main Methods

Collected AFP and DCP data from a multicenter database for HCC patients undergoing hepatectomy, focusing on pre-operative and early post-discharge periods.
Categorized AFP-DCP expression patterns (double-negative, single-positive, double-positive) based on marker levels (AFP ≥ 20ng/mL, DCP ≥ 40mAU/mL).
Analyzed changes in AFP-DCP patterns from pre- to post-operation and correlated them with recurrence-free survival (RFS) and overall survival (OS).

Main Results

Postoperative AFP-DCP patterns, unlike preoperative ones, were identified as independent risk factors for RFS and OS.
A higher number of positive tumor markers post-surgery correlated with decreased RFS and OS (P < 0.001).
For patients with positive preoperative markers, a decrease in positive markers post-surgery improved prognosis, with complete negativity yielding outcomes similar to pre-operative double-negative patients.

Conclusions

Postoperative AFP-DCP expression patterns are critical for prognostic evaluation after HCC hepatectomy.
Changes in AFP-DCP patterns from pre- to post-operation allow for dynamic prognostic risk stratification.
These findings support the development of individualized follow-up strategies for HCC patients post-surgery.

Keywords:

alpha-fetoprotein des-gamma (γ)-carboxy prothrombin hepatocellular carcinoma prognosis resection

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