Biological response under treatment and prognostic value of protein induced by vitamin K absence or antagonist-II in a French cohort of patients with hepatocellular carcinoma. Issue 10 (October 2020)

• Record Type: Journal Article
• Authors: Payancé, Audrey; Dioguardi Burgio, Marco; Peoc'h, Katell; Achahboun, Mohamed; Albuquerque, Miguel; Devictor, Julie; Chor, Hélène; Manceau, Hana; Soubrane, Olivier; Durand, François; Castera, Laurent; Bouattour, Mohamed; Paradis, Valérie
• Is Part Of: European journal of gastroenterology & hepatology. Volume 32:Issue 10(2020)
• Publication Date: 2020-10
• Subjects: biomarkers -- cirrhosis -- hepatocellular carcinoma -- protein induced by vitamin K absence or antagonist-II; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Digestive organs -- Diseases; Liver -- Diseases; Periodicals; 616.33
• DOI: 10.1097/MEG.0000000000001652
• Languages: English
• ISSNs: 0954-691X

Abstract

Abstract : Objectives: We have confirmed the diagnostic value of protein induced by vitamin K absence or antagonist-II (PIVKA-II) in a French cohort of patients with hepatocellular carcinoma (HCC). Herein, we aim to study the biological response under treatment and the prognostic value of PIVKA-II serum level in patients treated for HCC. Methods: Patients with primary HCC developed chronic liver disease with serum PIVKA-II, and alpha-fetoprotein (AFP) levels available at baseline and after first HCC treatment [within 3 months (M1–M3) and/or within 6–9 months (M6–M9)] were included. Results: A total of 94 patients were included. Median follow-up was 23 months (range 11–31 months). PIVKA-II levels significantly decreased from baseline to M1–M3 ( P = 0.002) and to M6–M9 ( P = 0.035). By multivariate analysis, biological response (M1–M3/baseline PIVKA-II ratio) independently and significantly predicted overall survival (OS). A ratio below 0.73 was able to identify patients with the better prognosis in the total population [OS: 27 months (range 17–31) vs. 17 (range 9–25); P = 0.008] and in patients who had transarterial chemoembolization or selective internal radiation therapy as first treatment approach [OS: 26 months (range 14–31) vs. 16 (range 9–25); P = 0.002 and 2-year OS of 73% vs. 30%; P = 0.009]. PIVKA-II serum levels at baseline and PIVKA-II biological response were significantly associated with radiological response. Conclusion: PIVKA-II serum level seems to be a good prognostic and promising biomarker for early monitoring treatment outcomes for patients with HCC. Abstract : Supplemental Digital Content is available in the text.