Clinical significance of half-lives of tumor markers α-fetoprotein and des-γ-carboxy prothrombin after hepatectomy for hepatocellular carcinoma

Aim: The prognostic significance of the half-lives (HLs) of a-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) in patients undergoing hepatectomy for hepatocellular carcinoma (HCC) is unclear. We evaluated the HLs of AFP and DCP in a cohort of such patients. Methods: This study included data on 202 patients with HCC who underwent curative hepatectomy and had preoperative AFP concentrations >= 100 ng/mL or DCP >= 200 mAU/mL. We calculated the HLs of AFP and DCP from their values just before and 1 month after hepatectomy. We identified three groups: a normalization group, tumor marker concentrations within normal range 1 month post-hepatectomy; a long group, HL of AFP >= 7 days or DCP >= 4 days; and a short group, remaining patients. We evaluated associations between HL and prognosis. Results: Three-year recurrence-free survival (RFS) in the normalization (n = 70), short (n = 71), and long groups (n= 61) was 41.3%, 46.0%, and 16.8%, respectively (P = 0.002). Five-year overall survival (OS) of normalization, short, and long groups was 72.6, 70.6 and 43.8%, respectively (P = 0.002). Multivariate analysis revealed that long HL is an independent risk factor for poor RFS (hazard ratio [HR] 2.21, P= 0.0006) and poor OS (HR 2.70, P = 0.004). The extrahepatic recurrence rate was 21.3% (13/61) in the long group, which is higher than in the normalization group (8.6%, 6/70) (P = 0.04) and short group (9.9%, 7/71) (P = 0.07). Conclusion: Post-hepatectomy HLs of AFP and DCP are predictors of long-term outcome in patients with HCC.