PIVKA-II Is the Best Prognostic Predictor in Patients with Hepatocellular Carcinoma after Radiofrequency Ablation TherapyTakahashi S. · Kudo M. · Chung H. · Inoue T. · Ishikawa E. · Kitai S. · Tatsumi C. · Ueda T. · Nagai T. · Minami Y. · Ueshima K.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kinki University School of Medicine, Osaka-Sayama, Japan
Objective: This study was undertaken to assess the prognostic predictor in patients with hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA). Methods: This study retrospectively evaluated clinical outcomes in a cohort of 179 Child-Pugh stage A cirrhotic patients who received curative RFA for naive HCC within Milan criteria. The median follow-up period was 40.5 months. Results: The cumulative survival rate was significantly lower in patients with prothrombin induced by vitamin K absence or antagonist II (PIVKA-II) ≥100 mAU/ml compared with PIVKA-II <100 mAU/ml (58.0 vs. 84.0% at 5 years; p < 0.001). The cumulative recurrence-free survival rates were significantly lower in patients with PIVKA-II ≥100 mAU/ml compared with PIVKA-II <100 mAU/ml (12.1 vs. 16.9% at 5 years; p < 0.032). The cumulative rate of maintaining period within Milan criteria was significantly lower in patients with PIVKA-II ≥100 mAU/ml compared with PIVKA-II <100 mAU/ml (34.1 vs. 55.6% at 5 years; p < 0.001). Cox regression analysis showed that low serum albumin (<3.5 g/dl; p = 0.002, RR 3.75, CI 1.64–8.56), a high level of PIVKA-II (≥100 mAU/ml; p = 0.04, RR 3.15, CI 1.45–6.87), and multiple nodules (p = 0.021, RR 2.61, CI 1.15–5.91) were independently significant mortality risk factors. Conclusion: In patients with Child-Pugh stage A HCC, the PIVKA-II level is the best prognostic predictor after curative RFA.
Masatoshi Kudo, MD, PhD, Division of Gastroenterology and Hepatology
Department of Internal Medicine, Kinki University School of Medicine
377-2 Ohno-Higashi, Osaka-Sayama 589-8511 (Japan)
Tel. +81 723 66 0221, ext. 3149, Fax +81 723 67 2880
Published online: December 17, 2008
Number of Print Pages : 8
Number of Figures : 4, Number of Tables : 3, Number of References : 42
Oncology (International Journal of Cancer Research and Treatment)
Vol. 75, No. Suppl. 1, Year 2008 (Cover Date: December 2008)
Journal Editor: Markman M. (Houston, Tex.)
ISSN: 0030-2414 (Print), eISSN: 1423-0232 (Online)
For additional information: http://www.karger.com/OCL