Research Papers:

Incorporation of alpha-fetoprotein(AFP) into subclassification of BCLC C stage hepatocellular carcinoma according to a 5-year survival analysis based on the SEER database

Nan Zhang, Jiajia Gu, Li Yin, Jing Wu, Ming-yu Du, Kai Ding, Teng Huang and Xia He _

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Oncotarget. 2016; 7:81389-81401. https://doi.org/10.18632/oncotarget.13232

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Nan Zhang1,2,3,*, Jiajia Gu2,*, Li Yin1,2,3, Jing Wu2, Ming-yu Du1,2,3, Kai Ding2,3,4, Teng Huang1,2,3, Xia He1,2,3,4

1The Fourth Clinical School of Nanjing Medical University, Nanjing, China

2Department of Radiation Oncology, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing, China

3Jiangsu Key Laboratory of Molecular and Translational Cancer Research, Nanjing, China

4Xuzhou Medical University, Xuzhou, China

*These authors contributed equally to this work

Correspondence to:

Xia He, email: [email protected]

Keywords: AFP, hepatocellular carcinoma, BCLC, SEER

Received: March 18, 2016     Accepted: November 01, 2016     Published: November 09, 2016


Purpose: To evaluate the effect of serum alpha-fetoprotein(AFP) on prognosis of patients with hepatocellular carcinoma (HCC) and put forward a proposal to modify BCLC staging system and the recommended treatment of patients with stage C.

Results: AFP positive was an independent poor prognostic factor of HCC. Race, pathological grade, T stage, M stage were also regarded to be significant predicted factors for poorer prognosis. When combining AFP status with AJCC stage, patients with A1 disease had a worse prognosis compared with those with A0 disease within each stage. Patients with A1 disease of each T/N stage had a worse prognosis than patients with A0 disease of the respective stage, and the prognosis of patients with A1 disease with lower T stages was worse or similar to that of patients with A0 disease of higher T stages.

Materials and Methods: We performed a retrospective study of all patients histologically diagnosed HCC from January 1, 2004, through December 31, 2008, from the SEER database.

Conclusions: AFP can be used as a subclassification index to modify the AJCC staging system of HCC. Since BCLC stage is the most widely used staging system, we recommend routine pre-treatment AFP testing as standard of care in HCC and incorporate AFP status into the BCLC staging system to modify the recommended treatment of patients with stage C.

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