caa a22 4500 445795646 CHVBK 20180317145124.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1007/s10620-011-1796-6 doi (NATIONALLICENCE)springer-10.1007/s10620-011-1796-6 Tumor Marker Levels Before and After Curative Treatment of Hepatocellular Carcinoma as Predictors of Patient Survival [Elektronische Daten] [Atsushi Nanashima, Naota Taura, Takafumi Abo, Tatsuki Ichikawa, Ichiro Sakamoto, Takeshi Nagayasu, Kazuhiko Nakao] Background: α-fetoprotein (AFP) is used as a marker for hepatocellular carcinoma (HCC), which is influenced by hepatitis. Protein-induced vitamin K absence or antagonist II (PIVKA-II) is a sensitive diagnostic marker. Changes in these markers after treatment may reflect curability and predict outcome. Methods: We conducted an analysis of prognosis in 470 HCC patients who received curative treatments, and examined the relationship between changes in AFP and PIVKA-II levels after 1month of treatment in 156 patients. Subjects were divided into three groups according to changes in both levels: (1) normal (L) group before treatment, (2) normalization (N) or (3) decreased but still above normal level or unchanged (ANU) group after treatment. Results: High AFP and PIVKA-II levels were significantly associated with poor tumor-free and overall survival. The presence of large size and advanced stage were significantly associated with prevalence of DU group. Overall survival in the AFP-L group was significantly better than that of other groups and overall survival in PIVKA-II-L and N groups were significantly better than that of the PIVKA-II-ANU groups. The combination of changes in the AFP- ANU and PIVKA-II- ANU groups showed the worst tumor-free and overall survivals. Multivariate analysis identified high pre-treatment levels of AFP and PIVKA-II and combination of AFP- ANU and PIVKA-II- ANU as significant determinants of poor tumor-free and overall survival, particularly in patients who underwent hepatectomy. Conclusion: We conclude that high levels of AFP or PIVKA-II after treatment for HCC did not sufficiently reflect curative efficacy of treatment and reflected a poor predictor of prognosis in HCC patients. Springer Science+Business Media, LLC, 2011 Hepatocellular carcinoma nationallicence PIVKA-II nationallicence AFP nationallicence Post-curative treatment change nationallicence Survival nationallicence Nanashima Atsushi Division of Surgical Oncology and Department of Surgery, Nagasaki University Hospital, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut Taura Naota Department of Gastroenterology and Hepatology, Nagasaki University Hospital, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut Abo Takafumi Division of Surgical Oncology and Department of Surgery, Nagasaki University Hospital, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut Ichikawa Tatsuki Department of Gastroenterology and Hepatology, Nagasaki University Hospital, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut Sakamoto Ichiro Department of Radiology, Nagasaki University Hospital, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut Nagayasu Takeshi Division of Surgical Oncology and Department of Surgery, Nagasaki University Hospital, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut Nakao Kazuhiko Department of Gastroenterology and Hepatology, Nagasaki University Hospital, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/10(2011-10-01), 3086-3100 0163-2116 56:10<3086 2011 56 10620 https://doi.org/10.1007/s10620-011-1796-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-011-1796-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Nanashima Atsushi Division of Surgical Oncology and Department of Surgery, Nagasaki University Hospital, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut NATIONALLICENCE 700 1- Taura Naota Department of Gastroenterology and Hepatology, Nagasaki University Hospital, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut NATIONALLICENCE 700 1- Abo Takafumi Division of Surgical Oncology and Department of Surgery, Nagasaki University Hospital, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut NATIONALLICENCE 700 1- Ichikawa Tatsuki Department of Gastroenterology and Hepatology, Nagasaki University Hospital, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut NATIONALLICENCE 700 1- Sakamoto Ichiro Department of Radiology, Nagasaki University Hospital, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut NATIONALLICENCE 700 1- Nagayasu Takeshi Division of Surgical Oncology and Department of Surgery, Nagasaki University Hospital, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut NATIONALLICENCE 700 1- Nakao Kazuhiko Department of Gastroenterology and Hepatology, Nagasaki University Hospital, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/10(2011-10-01), 3086-3100 0163-2116 56:10<3086 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer