Alpha-fetoprotein level to total tumor volume as a predictor of hepatocellular carcinoma recurrence after resection. A retrospective cohort study

摘要

BackgroundTotal tumor volume (TTV) and serum alfa fetoprotein (AFP) level are important risk factors linked with the high possibility of hepatocellular carcinoma (HCC) recurrence. The aim of the study was to evaluate the role of AFP/TTV ratio, as a prognostic marker, in the prediction of HCC recurrence after resection.MethodsPatients who underwent liver resection for HCC between 2010 and 2018 were retrospectively analyzed. Patients were divided into 2 groups; a group with AFP/TTV ≤2 and another group with AFP/TTV >2. Risk factors for HCC recurrence were recorded.ResultsA total of 286 HCC patients underwent liver resection (184 patients with AFP/TTV?≤?2, and 102 patients with AFP/TTV?>?2). There was a significant difference between the 2 groups in the preoperative total bilirubin level, serum AFP level, mean tumor diameter, TTV, operative blood loss, microvascular invasion and hospital stay (allPvalues?2 (HR?=?1.62, 95% CI?=?1.29–1.98,P?=?0.042), Macrovascular invasion (HR?=?2.03, 95% CI?=?2.17–2.38,P?=?0.021, and microvascular invasion (HR?=?1.36, 95% CI?=?1.08–1.77,P?=?0.019).ConclusionAFP/TTV ratio is a feasible prognostic marker for prediction of HCC recurrence after resection so, it can help in providing an intensive postoperative surveillance program to high risk patients for early detection and management of any recurrence.