Clinical usefulness of double biomarkers AFP and PIVKA‐II for subdividing prognostic groups in locally advanced hepatocellular carcinoma. (29th July 2013)

• Record Type: Journal Article
• Authors: Park, Hana; Kim, Seung Up; Park, Jun Young; Kim, Do Young; Ahn, Sang Hoon; Chon, Chae Yoon; Han, Kwang‐Hyub; Seong, Jinsil
• Is Part Of: Liver international. Volume 34:Number 2(2014:Mar.)
• Page Start: 313
• Page End: 321
• Publication Date: 2013-07-29
• Subjects: Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.12274
• Languages: English
• ISSNs: 1478-3223

Abstract

<abstract abstract-type="main" id="liv12274-abs-0001"> <title>Abstract</title> <sec id="liv12274-sec-0001" sec-type="section"> <title>Background & Aims</title> <p>In this study, we investigated the clinical usefulness of AFP and PIVKA‐II in subdividing prognostic groups in patients with locally advanced HCC treated locally.</p> </sec> <sec id="liv12274-sec-0002" sec-type="section"> <title>Methods</title> <p>Patients who had undergone local treatment for locally advanced HCC between 2001 and 2006 were enrolled. Response to treatment was defined as a reduction in AFP or PIVKA‐II by more than 50% from baseline levels at 1 month after the treatment completion. Patients were divided according to their AFP and PIVKA‐II response: A↓P↓ [AFP response (+) and PIVKA‐II response (+)]; A↓P↑ [AFP response (+) and PIVKA‐II response (−)]; A↑P↓ [AFP response (−) and PIVKA‐II response (+)]; A↑P↑ [AFP response (−) and PIVKA‐II response (−)]. Clinical characteristics and prognosis were compared between groups.</p> </sec> <sec id="liv12274-sec-0003" sec-type="section"> <title>Results</title> <p>Patients were subdivided into four groups by the change in the level of the biomarkers AFP and PIVKA‐II, and the survival outcomes of each group were distinct. Among patients with an AFP response, further subdivision by PIVKA‐II response revealed that those in the A↓P↓ group had a longer median progression‐free survival (PFS) and overall survival (OS) compared with those in the A↓P↑ group (PFS: 16.2 vs. 5.1 months, <italic>P </italic>=<italic> </italic>0.009; OS: 26.3 vs. 7.3 months, <italic>P </italic>=<italic> </italic>0.017). Combination of AFP and PIVKA‐II response showed a predictive power for PFS and OS comparable to radiological criteria and better than AFP response alone.</p> </sec> <sec id="liv12274-sec-0004" sec-type="section"> <title>Conclusions</title> <p>In patients with locally advanced HCC, the use of a combination of two biomarkers, AFP and PIVKA‐II, appears useful in predicting treatment outcomes through the subdivision of prognostic groups.</p> </sec> </abstract>