Key result
High pre-treatment serum AFP-L3% was significantly associated with poor overall survival (HR 1.65) and disease-free survival (HR 1.80) in patients with hepatocellular carcinoma.
Why the study?
Does high pre-treatment serum AFP-L3% predict poor overall survival and disease-free survival in patients with hepatocellular carcinoma?
Meta-Analysis (n=4,465)
Does high pre-treatment serum AFP-L3% predict poor overall survival and disease-free survival in patients with hepatocellular carcinoma?
Hazard Ratio: 1.65 (95% CI 1.45–1.89)
p-value: p=<0.00001
High pre-treatment serum AFP-L3% is a significant predictor of poor overall and disease-free survival in patients with hepatocellular carcinoma, including those with low total AFP concentrations.
May aid HCC prognostication; extends meta-analytic support yet leaves open prospective validation.
BACKGROUND: Serum lens culinaris agglutinin-reactive fraction of α-fetoprotein (AFP-L3%) has been widely used for HCC diagnosis and follow-up surveillance as tumor serologic marker. However, the prognostic value of high pre-treatment serum AFP-L3% in patients with hepatocellular carcinoma (HCC) remains controversial. We therefore conduct a meta-analysis to assess the relationship between high pre-treatment serum AFP-L3% and clinical outcome of HCC. METHODS: Eligible studies were identified through systematic literature searches. A meta-analysis of fifteen studies (4,465 patients) was carried out to evaluate the association between high pre-treatment serum AFP-L3% and overall survival (OS) and disease-free survival (DFS) in HCC patients. Sensitivity and subgroup analyses were also conducted in this meta-analysis. RESULTS: Our analysis results showed that high pre-treatment serum AFP-L3% implied poor OS (HR: 1.65, 95%CI: 1.45-1.89 p<0.00001) and DFS (HR: 1.80, 95% CI: 1.49-2.17 p<0.00001) of HCC. Subgroup analysis revealed that there was association between pre-treatment serum AFP-L3% and endpoint (OS and DFS) in low AFP concentration HCC patients (HR: 1.96, 95% CI: 1.24-3.10, p = 0.004; HR: 2.53, 95% CI: 1.09-5.89, p = 0.03, respectively). CONCLUSION: The current evidence suggests that high pre-treatment serum AFP-L3% levels indicated a poor prognosis for patients with HCC and AFP-L3% may have significant prognostic value in HCC patients with low AFP concentration.
No takes yet. Share an insight, caveat, or question.
Cheng et al. (2014) conducted a meta-analysis in Hepatocellular carcinoma (n=4,465). High pre-treatment serum AFP-L3% vs. Low pre-treatment serum AFP-L3% was evaluated on Overall survival (OS) (HR 1.65, 95% CI 1.45-1.89, p=<0.00001). High pre-treatment serum AFP-L3% was significantly associated with poor overall survival (HR 1.65) and disease-free survival (HR 1.80) in patients with hepatocellular carcinoma.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: