Initial alpha-fetoprotein response predicts survival, recurrence after radiofrequency ablation
Measurement of serial alpha-fetoprotein (AFP) levels to evaluate biological response may help predict overall survival and intrahepatic remote recurrence after radiofrequency ablation (RFA), suggests a recent study.
“Therefore, an initial AFP response may aid in determining the need of closer follow-up as a therapeutic response indicator of RFA,” according to the investigators.
Of the 255 patients included in the analysis, 156 (61.2 percent) developed intrahepatic recurrence. Radiologic progression occurred in 54.8 percent (86/157) and 71.4 percent (70/98) of the AFP responders and nonresponders, respectively.
Multivariate analysis revealed that a history of previous treatment (hazard ratio [HR] for percutaneous ethanol injection vs none, 2.037; p=0.015; HR for transarterial chemoembolization vs none, 2.642; p<0.001) and an initial AFP nonresponse (HR, 1.899; p<0.001) independently predicted accelerated progression following RFA.
Furthermore, overall survival was significantly unfavourable (HR, 3.581; p<0.001) and the risk of intrahepatic remote recurrence was greater (HR, 5.385; p<0.001) among patients who had a history of previous treatment and did not achieve an initial AFP response compared with those with an initial AFP response and no history of previous treatment.
The investigators prospectively enrolled naïve as well as previously treated patients with solitary hepatitis B virus-related hepatocellular carcinoma <5 cm in this study to identify prognostic factors included AFP for overall survival and intrahepatic recurrence after RFA.
An initial AFP response was defined as a ≥50-percent reduction from baseline to 1 month after RFA. Tumour responses were assessed using the modified response evaluation criteria in solid tumours.
“RFA is effective for early-stage hepatocellular carcinoma but recurrence is problem,” the investigators said.