Prognostic role of alpha-fetoprotein response after hepatocellular carcinoma resection

Table 1 Clinicopathological features of patients in the three alpha-fetoprotein response groups n (%)

	Total(n = 334)	Normal group(n = 178)	Response group(n = 129)	Non-response group(n = 27)	P value
Gender
Male	155 (46.41)	86 (48.31)	56 (43.41)	13 (48.15)	0.684
Female	179 (53.59)	92 (51.69)	73 (56.59)	14 (51.85)
Age (mean ± SD, yr)	58.76 ± 10.09	59.94 ± 9.56	57.56 ± 10.43	56.70 ± 11.16	0.066
HBV
No	148 (44.31)	81 (45.51)	54 (41.86)	13 (48.15)	0.749
Yes	186 (55.69)	97 (54.49)	75 (58.14)	14 (51.85)
HCV
No	274 (82.04)	151 (84.83)	103 (79.84)	20 (74.07)	0.283
Yes	60 (17.96)	27 (15.17)	26 (20.16)	7 (25.93)
Platelet × 103, median (range), n = 332	191 (14, 850)	191 (49, 850)	193 (14, 690)	155 (36, 444)	0.361
Tumor size (cm), median (range), n = 333	4.3 (0.5, 26.5)	4 (0.5, 26.5)	5.1 (0.8, 18)	4.75 (1.3, 14)	0.204
No. of tumors
Single	262 (78.44)	143 (80.34)	99 (76.74)	20 (74.07)	0.637
Multiple	72 (21.56)	35 (19.66)	30 (23.26)	7 (25.93)
mVI
No	254 (76.05)	142 (79.78)	95 (73.64)	17 (62.96)	0.116
Yes	80 (23.95)	36 (20.22)	34 (26.36)	10 (37.04)
Stage
Stage I	204 (61.08)	114 (64.04)	75 (58.14)	15 (55.56)	0.479
Stage II or higher	130 (38.92)	64 (35.96)	54 (41.86)	12 (44.44)
Resection margin n = 282
Free margin	264 (93.62)	141 (93.38)	103 (94.50)	20 (90.91)	0.808
Positive margin	18 (6.38)	10 (6.62)	6 (5.50)	2 (9.09)
Anti-viral treatment
No	179 (53.59)	92 (51.69)	71 (55.04)	16 (59.26)	0.699
Yes	155 (46.41)	86 (48.31)	58 (44.96)	11 (40.74)
Recurrence
No	181 (54.19)	103 (57.87)	69 (53.49)	9 (33.33)	0.057
Yes	153 (45.81)	75 (42.13)	60 (46.51)	18 (66.67)
Death
No	282 (84.43)	156 (87.64)	107 (82.95)	19 (70.37)	0.059
Yes	52 (15.57)	22 (12.36)	22 (17.05)	8 (29.63)
Time follow up (mo), median (range)	35.63 (0.56, 176.6)	37.96 (0.56, 130.77)	35.06 (3.76, 176.60)	14.06 (2.83, 140.93)	0.007

HBV: Hepatitis B virus; HCV: Hepatitis C virus.

Table 2 Univariate and multivariate analysis of factors associated with recurrence

	Univariate		Multivariate
	HR (95%CI)	P value	HR (95%CI)	P value
Gender
Male	1
Female	0.882 (0.64-1.21)	0.443
Age (yr)	0.997 (0.98-1.01)	0.758
HBV
No	1
Yes	1.079 (0.78-1.49)	0.641
HCV
No	1
Yes	1.373 (0.92-2.05)	0.12
Platelet × 103	1.002 (0.98-1.02)	0.775
Tumor size (cm)	1.058 (1.02-1.10)	0.003	1.040 (0.99-1.08)	0.059
No. of tumor
Single	1		1
Multiple	1.793 (1.26-2.54)	0.001	1.646 (1.15-2.35)	0.006
mVI
No	1		1
Yes	1.889 (1.30-2.73)	0.001	1.573 (1.05-2.35)	0.026
Stage
Stage I	1
Stage II or higher	1.535 (1.10-2.12)	0.01
Resection margin
Free margin	1
Positive margin	1.359 (0.69-2.67)	0.375
Anti-viral treatment
No	1
Yes	0.935 (0.68-1.28)	0.682
AFP
Normal group	1		1
Response group	1.137 (0.80-1.59)	0.458	1.067 (0.75-1.50)	0.711
Non-response group	2.438 (1.45-4.08)	0.001	2.425 (1.42-4.13)	0.001

AFP: Alpha-fetoprotein; HBV: Hepatitis B virus; HCV: Hepatitis C virus.

Table 3 Univariate and multivariate analysis of factors associated with overall survival

	Univariate		Multivariate
	HR (95%CI)	P value	HR (95%CI)	P value
Gender
Male	1
Female	1.083 (0.62-1.88)	0.775
Age (yr)	0.998 (0.97-1.02)	0.905
HBV
No	1
Yes	1.032 (0.59-1.79)	0.909
HCV
No	1
Yes	1.154 (0.56-2.37)	0.696
Platelet × 103	1.002 (0.99-1.00)	0.117
Tumor size (cm)	1.062 (0.99-1.13)	0.066
No. of tumor
Single	1		1
Multiple	2.240 (1.27-3.94)	0.005	1.991 (1.12-3.52)	0.018
mVI
No	1		1
Yes	3.324 (1.85-5.95)	0	3.240 (1.77-5.90)	0
Stage
Stage I	1
Stage II or higher	1.941 (1.11-3.38)	0.019
Resection margin
Free margin	1
Positive margin	2.544 (1.00-6.47)	0.05
Anti-viral treatment
No	1
Yes	0.786 (0.45-1.36)	0.392
Recurrence
No	1
Yes	7.917 (3.56-17.56)	0
AFP
Normal group	1		1
Response group	1.338 (0.74-2.41)	0.334	1.168 (0.64-2.12)	0.612
Non-response group	3.635 (1.61-8.18)	0.002	3.621 (1.59-8.21)	0.002

AFP: Alpha-fetoprotein; HBV: Hepatitis B virus; HCV: Hepatitis C virus.