Scoring system based on tumor markers and Child-Pugh classification for HCC patients who underwent liver resection

Anticancer Res. 2015 Apr;35(4):2157-63.

Abstract

Background: The long-term prognosis of hepatocellular carcinoma (HCC) patients after hepatic resection (HR) remains poor because of limited liver function and frequent recurrences. We created a prognostic system of HCC based on tumor markers and Child-Pugh classification.

Patients and methods: This study investigated 427 HCC patients and three tumor markers (alpha-fetoprotein (AFP), Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), des-γ -carboxyprothrombin (DCP)) in relation to Child-Pugh classification by the stepwise Cox regression model for establishing a tumor marker staging (TMS).

Results: The TMS shows four levels (0/1/2/3) with 5-year recurrence rate of each stage of 76.7, 72.3, 80.9 and 100%, respectively, and 5-year overall survival of 77.0, 68.7, 52.1 and 28.9%, respectively. This TMS appears to be a better model to predict the recurrence and survival of HCC patients after hepatectomy than only the number of positive tumor markers.

Conclusion: TMS is a useful staging system to evaluate biological status and background liver function.

Keywords: Hepatocellular carcinoma (HCC); Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3); alpha-fetoprotein (AFP); des-γ-carboxyprothrombin (DCP); tumor marker.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers
  • Biomarkers, Tumor / metabolism
  • Carcinoma, Hepatocellular / classification
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / surgery*
  • Female
  • Hepatectomy*
  • Humans
  • Lens Plant / chemistry
  • Liver / surgery
  • Liver Neoplasms / classification
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / classification
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / surgery*
  • Protein Precursors / immunology
  • Prothrombin / immunology
  • alpha-Fetoproteins / metabolism

Substances

  • Biomarkers
  • Biomarkers, Tumor
  • Protein Precursors
  • alpha-Fetoproteins
  • acarboxyprothrombin
  • Prothrombin