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Evaluation of seven different staging systems for alpha-fetoprotein expression in hepatocellular carcinoma after hepatectomy

Alpha-fetoprotein (AFP) represents the most important biomarker for hepatocellular carcinoma (HCC). The aim of this study was to identify the optimal staging system to predict the survival of AFP-negative and AFP-positive patients. This study analyzed the data of 431 AFP-negative HCC patients who ha... Full description

Journal Title: Tumor Biology 2013, Vol.34(2), pp.1061-1070
Main Author: Zhou, Jianguo
Other Authors: Yan, Tao , Bi, Xinyu , Zhao, Hong , Huang, Zhen , Zhang, Yefan , Li, Yuan , Feng, Li , Wang, Jing , Cai, Jianqiang
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: ISSN: 1010-4283 ; E-ISSN: 1423-0380 ; DOI: 10.1007/s13277-013-0646-x
Link: http://dx.doi.org/10.1007/s13277-013-0646-x
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recordid: springer_jour10.1007/s13277-013-0646-x
title: Evaluation of seven different staging systems for alpha-fetoprotein expression in hepatocellular carcinoma after hepatectomy
format: Article
creator:
  • Zhou, Jianguo
  • Yan, Tao
  • Bi, Xinyu
  • Zhao, Hong
  • Huang, Zhen
  • Zhang, Yefan
  • Li, Yuan
  • Feng, Li
  • Wang, Jing
  • Cai, Jianqiang
subjects:
  • Hepatocellular carcinoma
  • Alpha-fetoprotein
  • Clinical staging system
  • Survival
ispartof: Tumor Biology, 2013, Vol.34(2), pp.1061-1070
description: Alpha-fetoprotein (AFP) represents the most important biomarker for hepatocellular carcinoma (HCC). The aim of this study was to identify the optimal staging system to predict the survival of AFP-negative and AFP-positive patients. This study analyzed the data of 431 AFP-negative HCC patients who had previously undergone surgery and 471 AFP-positive HCC candidates. Kaplan–Meier (K-M) survival estimates were plotted, and the P values were assessed using log-rank tests. The Akaike information criterion (AIC) was calculated using the results of a Cox’s regression to compare the overall assessment of the seven different staging systems. The AFP-positive group displayed characteristics of poor tumor biological behavior (tumor multiplicity [ P  = 0.032], low grade differentiation [ P  = 0.000] and carcinoma cell embolus [ P  = 0.031]), poor liver function (Child–Pugh B classification [ P  = 0.003], abnormal prothrombin time activity [ P  = 0.037] and moderate/severe cirrhosis [ P  = 0.000]) and increased operative difficulties (transfusion; P  = 0.001). TNM7th staging showed the lowest AIC value (1,279.528) for the AFP-negative group, while the Barcelona Clinic Liver Cancer (BCLC) staging system revealed the lowest AIC value (1,991.233) for the AFP-positive group. In conclusion, among the seven favorable staging systems, BCLC staging was superior for the AFP-positive group, while the TNM7th was a more appropriate staging model for the AFP-negative group.
language: eng
source:
identifier: ISSN: 1010-4283 ; E-ISSN: 1423-0380 ; DOI: 10.1007/s13277-013-0646-x
fulltext: fulltext
issn:
  • 1423-0380
  • 14230380
  • 1010-4283
  • 10104283
url: Link


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titleEvaluation of seven different staging systems for alpha-fetoprotein expression in hepatocellular carcinoma after hepatectomy
creatorZhou, Jianguo ; Yan, Tao ; Bi, Xinyu ; Zhao, Hong ; Huang, Zhen ; Zhang, Yefan ; Li, Yuan ; Feng, Li ; Wang, Jing ; Cai, Jianqiang
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subjectHepatocellular carcinoma ; Alpha-fetoprotein ; Clinical staging system ; Survival
descriptionAlpha-fetoprotein (AFP) represents the most important biomarker for hepatocellular carcinoma (HCC). The aim of this study was to identify the optimal staging system to predict the survival of AFP-negative and AFP-positive patients. This study analyzed the data of 431 AFP-negative HCC patients who had previously undergone surgery and 471 AFP-positive HCC candidates. Kaplan–Meier (K-M) survival estimates were plotted, and the P values were assessed using log-rank tests. The Akaike information criterion (AIC) was calculated using the results of a Cox’s regression to compare the overall assessment of the seven different staging systems. The AFP-positive group displayed characteristics of poor tumor biological behavior (tumor multiplicity [ P  = 0.032], low grade differentiation [ P  = 0.000] and carcinoma cell embolus [ P  = 0.031]), poor liver function (Child–Pugh B classification [ P  = 0.003], abnormal prothrombin time activity [ P  = 0.037] and moderate/severe cirrhosis [ P  = 0.000]) and increased operative difficulties (transfusion; P  = 0.001). TNM7th staging showed the lowest AIC value (1,279.528) for the AFP-negative group, while the Barcelona Clinic Liver Cancer (BCLC) staging system revealed the lowest AIC value (1,991.233) for the AFP-positive group. In conclusion, among the seven favorable staging systems, BCLC staging was superior for the AFP-positive group, while the TNM7th was a more appropriate staging model for the AFP-negative group.
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titleEvaluation of seven different staging systems for alpha-fetoprotein expression in hepatocellular carcinoma after hepatectomy
descriptionAlpha-fetoprotein (AFP) represents the most important biomarker for hepatocellular carcinoma (HCC). The aim of this study was to identify the optimal staging system to predict the survival of AFP-negative and AFP-positive patients. This study analyzed the data of 431 AFP-negative HCC patients who had previously undergone surgery and 471 AFP-positive HCC candidates. Kaplan–Meier (K-M) survival estimates were plotted, and the P values were assessed using log-rank tests. The Akaike information criterion (AIC) was calculated using the results of a Cox’s regression to compare the overall assessment of the seven different staging systems. The AFP-positive group displayed characteristics of poor tumor biological behavior (tumor multiplicity [ P  = 0.032], low grade differentiation [ P  = 0.000] and carcinoma cell embolus [ P  = 0.031]), poor liver function (Child–Pugh B classification [ P  = 0.003], abnormal prothrombin time activity [ P  = 0.037] and moderate/severe cirrhosis [ P  = 0.000]) and increased operative difficulties (transfusion; P  = 0.001). TNM7th staging showed the lowest AIC value (1,279.528) for the AFP-negative group, while the Barcelona Clinic Liver Cancer (BCLC) staging system revealed the lowest AIC value (1,991.233) for the AFP-positive group. In conclusion, among the seven favorable staging systems, BCLC staging was superior for the AFP-positive group, while the TNM7th was a more appropriate staging model for the AFP-negative group.
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abstractAlpha-fetoprotein (AFP) represents the most important biomarker for hepatocellular carcinoma (HCC). The aim of this study was to identify the optimal staging system to predict the survival of AFP-negative and AFP-positive patients. This study analyzed the data of 431 AFP-negative HCC patients who had previously undergone surgery and 471 AFP-positive HCC candidates. Kaplan–Meier (K-M) survival estimates were plotted, and the P values were assessed using log-rank tests. The Akaike information criterion (AIC) was calculated using the results of a Cox’s regression to compare the overall assessment of the seven different staging systems. The AFP-positive group displayed characteristics of poor tumor biological behavior (tumor multiplicity [ P  = 0.032], low grade differentiation [ P  = 0.000] and carcinoma cell embolus [ P  = 0.031]), poor liver function (Child–Pugh B classification [ P  = 0.003], abnormal prothrombin time activity [ P  = 0.037] and moderate/severe cirrhosis [ P  = 0.000]) and increased operative difficulties (transfusion; P  = 0.001). TNM7th staging showed the lowest AIC value (1,279.528) for the AFP-negative group, while the Barcelona Clinic Liver Cancer (BCLC) staging system revealed the lowest AIC value (1,991.233) for the AFP-positive group. In conclusion, among the seven favorable staging systems, BCLC staging was superior for the AFP-positive group, while the TNM7th was a more appropriate staging model for the AFP-negative group.
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doi10.1007/s13277-013-0646-x
pages1061-1070
date2013-04