Abdominal Radiology

, Volume 44, Issue 10, pp 3304–3311 | Cite as

Alpha-fetoprotein assessment for hepatocellular carcinoma after transarterial chemoembolization

  • Min Tian
  • Xiaoying Zhang
  • Guihua Huang
  • Wenzhe Fan
  • Jiaping Li
  • Yingqiang ZhangEmail author
Interventional Radiology



To evaluate whether AFP classification criteria correlate with tumor response measured using the European Association for the Study of the Liver (EASL) and predicate survival in patients with hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE).


Data from 143 consecutive patients with unresectable HCC and elevated AFP (> 20 ng/mL), who underwent TACE as initial treatment between January 2011 and December 2015 were collected, retrospectively. AFP response was classified as follows: complete response, normalization of AFP; partial response, > 50% decrease from baseline; stable disease, − 50 to + 30% change from baseline; or progressive disease, > 30% increase from baseline. Response rates according to AFP and EASL criteria were compared, and associations between the AFP response and overall survival (OS) were evaluated.


The k value for agreement between AFP criteria and EASL criteria was 0.52 (moderate), with response rates of 42.7% and 41.3%, respectively (P = 0.811). The OS of responders was significantly longer compared with non-responders for both AFP (21 vs. 6 months, P < 0.001) and EASL (23 vs. 6 months, P < 0.001). Multivariate analysis revealed that the AFP response (hazard ratio [HR], 0.430, 95% CI, 0.233–0.794; P = 0.007), EASL response (HR, 0.343; 95% CI, 0.176–0.666; P = 0.002), and macroscopic vascular invasion (HR, 2.104; 95% CI, 1.403–3.154; P < 0.001) were significantly associated with OS.


The defined AFP classification criteria was moderate correlated with EASL criteria and predicted the outcome in patients with HCC who underwent TACE.


Alpha-fetoprotein Transarterial chemoembolization Hepatocellular carcinoma Assessment Radiology Survival 


Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to declare.

Supplementary material

261_2019_2116_MOESM1_ESM.tif (210 kb)
Supplementary material 1 (TIFF 210 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Radiology, Hunan Provincial People’s HospitalThe First Affiliated Hospital of Hunan Normal UniversityChangshaChina
  2. 2.Health Management Center, The Seventh Affiliated HospitalSun Yat-sen UniversityShenzhenChina
  3. 3.Digestive Disease Center, The Seventh Affiliated HospitalSun Yat-sen UniversityShenzhenChina
  4. 4.Department of Interventional Oncology, The First Affiliated HospitalSun Yat-sen UniversityGuangzhouChina
  5. 5.Department of Interventional Radiology, The Seventh Affiliated HospitalSun Yat-sen UniversityShenzhenPeople’s Republic of China

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