Skip to main content
SpringerLink
Log in

The Value of Serum α-Fetoprotein in Predicting Tumor Recurrence After Liver Transplantation for Hepatocellular Carcinoma

  • Original Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Background Many patients with hepatocellular carcinoma (HCC) who undergo liver transplantation (LT) subsequently develop tumor recurrence; this is the main factor affecting long-term survival after LT. Factors associated with tumor recurrence should be determined to improve the outcome of LT. The purpose of the study was to evaluate the value of α-fetoprotein (AFP) in forecasting tumor recurrence after LT for patients with HCC. Methods AFP data before and after LT for 97 patients with HCC who underwent LT in our center were analyzed retrospectively. Results The mean follow-up time was 17.1 ± 2.1 months for all 97 patients, overall tumor recurrence rate was 32.9% (32/97), and mean recurrence time was 7.2 ± 3.2 months. The most common tumor recurrence sites were liver, lung, skeleton, and other sites. Pre-transplant AFP levels >400 ng/ml were associated with higher tumor recurrence. Post-transplant AFP levels not decreasing to ≤20 ng/ml within 2 months were also indicative of higher risk of recurrence. Conclusions Pre-transplant AFP and the dynamic change of AFP after LT were valuable in predicting tumor recurrence after LT for patients with HCC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Zheng SS, Liang TB, Wang WL, Huang DS, Shen Y, Zhang M, Xu X, Mou LJ (2002) Clinical experience in liver transplantation from an organ transplantation center in China. HBPD Int 1(4):487–491

    PubMed  Google Scholar 

  2. Tan KC (2003) Liver transplantation for hepatocellular carcinoma: how far can we push the envelope? Singapore Med J 44(6):309–311

    PubMed  CAS  Google Scholar 

  3. Cha C, Fong Y, Jarnagin WR, Blumgart LH, DeMatteo RP (2003) Predictors and patterns of recurrence after resection of hepatocellular carcinoma. J Am Coll Surg 197(5):753–758. doi:10.1016/j.jamcollsurg.2003.07.003

    Article  PubMed  Google Scholar 

  4. Regalia E, Coppa J, Pulvirenti A, Romito R, Schiavo M, Burgoa L, Mazzaferro V (2001) Liver transplantation for small hepatocellular carcinoma in cirrhosis: analysis of our experience. Transplant Proc 33(1–2):1442–1444. doi:10.1016/S0041-1345(00)02546-X

    Article  PubMed  CAS  Google Scholar 

  5. Zheng SS, Xu X, Liang TB, Wang WL, Shen Y, Zhang M, Wu J, Lu AW, Shao ZX (2005) Liver transplantation for hepatocellular carcinoma: prognostic analysis of 89 cases. Zhonghua Wai Ke Za Zhi 43(7):450–454

    PubMed  Google Scholar 

  6. Figueras J, Ibanez L, Ramos E, Jaurrieta E, Ortiz-de-Urbina J, Pardo F, Mir J, Loinaz C, Herrera L, Lopez-Cillero P, Santoyo J (2001) Selection criteria for liver transplantation in early-stage hepatocellular carcinoma with cirrhosis: results of a multicenter study. Liver Transplant 7(10):877–883. doi:10.1053/jlts.2001.27856

    Article  CAS  Google Scholar 

  7. Ho MC, Wu YM, Hu RH, Ko WJ, Yang PM, Lai MY, Lin MH, Lin HY, Lee PH (2004) Liver transplantation for patients with hepatocellular carcinoma. Transplant Proc 36(8):2291–2292. doi:10.1016/j.transproceed.2004.08.098

    Article  PubMed  Google Scholar 

  8. Vogelzang NJ, Lange PH, Goldman A, Vessela RH, Fraley EE, Kennedy BJ (1982) Acute changes of alpha-fetoprotein and human chorionic gonadotropin during induction chemotherapy of germ cell tumors. Cancer Res 42(11):4855–4861

    PubMed  CAS  Google Scholar 

  9. Mazzaferro V, Regalia E, Doci R, Andreola S, Pulvirenti A, Bozzetti F, Montalto F, Ammatuna M, Morabito A, Gennari L (1996) Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 334(11):693–699. doi:10.1056/NEJM199603143341104

    Article  PubMed  CAS  Google Scholar 

  10. Marsh JW, Dvorchik I, Bonham CA, Iwatsuki S (2000) Is the pathologic TNM staging system for patients with hepatoma predictive of outcome? Cancer 88(3):538–543. doi:10.1002/(SICI)1097-0142(20000201)88:3<538::AID-CNCR7>3.0.CO;2-H

  11. Zavaglia C, De Carlis L, Alberti AB, Minola E, Belli LS, Slim AO, Airoldi A, Giacomoni A, Rondinara G, Tinelli C, Forti D, Pinzello G (2005) Predictors of long-term survival after liver transplantation for hepatocellular carcinoma. Am J Gastroenterol 100(12):2708–2716. doi:10.1111/j.1572-0241.2005.00289.x

    Article  PubMed  Google Scholar 

  12. Pawlik TM, Delman KA, Vauthey JN, Nagorney DM, Ng IO, Ikai I, Yamaoka Y, Belghiti J, Lauwers GY, Poon RT, Abdalla EK (2005) Tumor size predicts vascular invasion and histologic grade: Implications for selection of surgical treatment for hepatocellular carcinoma. Liver Transpl 11(9):1086–1092. doi:10.1002/lt.20472

    Article  PubMed  Google Scholar 

  13. Lohe F, Angele MK, Gerbes AL, Lohrs U, Jauch KW, Schauer RJ (2005) Tumour size is an important predictor for the outcome after liver transplantation for hepatocellular carcinoma. Eur J Surg Oncol 31(9):994–999. doi:10.1016/j.ejso.2005.06.003

    Article  PubMed  CAS  Google Scholar 

  14. Merli M, Nicolini G, Gentili F, Novelli G, Iappelli M, Casciaro G, Di Tondo U, Pecorella I, Marasco A, Onetti Muda A, Nudo F, Mennini G, Ginanni Corradini S, Riggio O, Berloco P, Attili AF, Rossi M (2005) Predictive factors of outcome after liver transplantation in patients with cirrhosis and hepatocellular carcinoma. Transplant Proc 37(6):2535–2540. doi:10.1016/j.transproceed.2005.06.031

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This study was supported by a research grant from National Basic Research program of China (973 program, 2003CB515505) and the Fund for Science and Technology Department of Zhejiang Province (J20040701).

Author information

Authors and Affiliations

  1. Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Key Lab of Combined Muti-Organ Transplantation, Ministry of Health, Zhejiang University, Hangzhou, 310003, China

    Xiao Xu, Qing-Hong Ke, Zhe-Xin Shao, Jian Wu, Jun Chen, Lin Zhou & Shu-Sen Zheng

Authors
  1. Xiao Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Qing-Hong Ke
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zhe-Xin Shao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jian Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jun Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lin Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Shu-Sen Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shu-Sen Zheng.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Xu, X., Ke, QH., Shao, ZX. et al. The Value of Serum α-Fetoprotein in Predicting Tumor Recurrence After Liver Transplantation for Hepatocellular Carcinoma. Dig Dis Sci 54, 385–388 (2009). https://doi.org/10.1007/s10620-008-0349-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-008-0349-0

Keywords

Search

Navigation