Advertisement

Digestive Diseases and Sciences

, Volume 54, Issue 2, pp 385–388 | Cite as

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

  • Xiao Xu
  • Qing-Hong Ke
  • Zhe-Xin Shao
  • Jian Wu
  • Jun Chen
  • Lin Zhou
  • Shu-Sen Zheng
Original Article

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.

Keywords

α-Fetoprotein Recurrence Liver transplantation Hepatocellular carcinoma 

Notes

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).

References

  1. 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):487–491PubMedGoogle Scholar
  2. 2.
    Tan KC (2003) Liver transplantation for hepatocellular carcinoma: how far can we push the envelope? Singapore Med J 44(6):309–311PubMedGoogle Scholar
  3. 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 PubMedCrossRefGoogle Scholar
  4. 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 PubMedCrossRefGoogle Scholar
  5. 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):450–454PubMedGoogle Scholar
  6. 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 CrossRefGoogle Scholar
  7. 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 PubMedCrossRefGoogle Scholar
  8. 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):4855–4861PubMedGoogle Scholar
  9. 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 PubMedCrossRefGoogle Scholar
  10. 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-HGoogle Scholar
  11. 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 PubMedCrossRefGoogle Scholar
  12. 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 PubMedCrossRefGoogle Scholar
  13. 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 PubMedCrossRefGoogle Scholar
  14. 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 PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Xiao Xu
    • 1
  • Qing-Hong Ke
    • 1
  • Zhe-Xin Shao
    • 1
  • Jian Wu
    • 1
  • Jun Chen
    • 1
  • Lin Zhou
    • 1
  • Shu-Sen Zheng
    • 1
  1. 1.Department of Hepatobiliary and Pancreatic SurgeryThe First Affiliated Hospital, College of Medicine, Key Lab of Combined Muti-Organ Transplantation, Ministry of Health, Zhejiang UniversityHangzhouChina

Personalised recommendations