A Longitudinal Study of AFP Trajectories and Clinical Outcomes in Intermediate-Stage Hepatocellular Carcinoma After Hepatectomy

Figures & data

Figure 1 Flow chart of the cohort. HCC=hepatocellular carcinoma; TACE=transarterial chemoembolization; BCLC= Barcelona Clinic Liver Cancer.

Table 1 Baseline Characteristics of Patients Stratified by Trajectory Classes of AFP

Class	Low-Stable	High-Rising	Sharp-Falling	P-value
N	51	52	41
Age (years)	53.8 ± 12.4	47.8 ± 12.7	47.7 ± 11.5	0.021
Gender				0.436
Male	46 (90.2%)	50 (96.2%)	37 (90.2%)
Female	5 (9.8%)	2 (3.8%)	4 (9.8%)
AFP (ng/mL)				<0.001
< 25	51 (100.0%)	0 (0.0%)	0 (0.0%)
≥25	0 (0.0%)	52 (100.0%)	41 (100.0%)
Log AFP (Mean ± SD)	0.8 ± 0.3	3.1 ± 1.2	3.4 ± 0.8	<0.001
Child-Pugh class				0.227
A	47 (92.2%)	42 (80.8%)	34 (82.9%)
B	4 (7.8%)	10 (19.2%)	7 (17.1%)
Diameter of main tumor (cm)				0.385
Mean ± SD	5.8 ± 2.3	6.8 ± 2.7	6.2 ± 2.3	0.108
< 5	21 (41.2%)	15 (28.8%)	16 (39.0%)
≥5	30 (58.8%)	37 (71.2%)	25 (61.0%)
Location of Lesions				0.958
Unilobar	37 (72.5%)	39 (75.0%)	30 (73.2%)
Bilobar	14 (27.5%)	13 (25.0%)	11 (26.8%)
No. of intrahepatic lesions				0.569
2	32 (62.7%)	29 (55.8%)	25 (61.0%)
3	5 (9.8%)	5 (9.6%)	1 (2.4%)
>3	14 (27.5%)	18 (34.6%)	15 (36.6%)

Notes: Differences are compared using the chi-square test (or Fisher’s exact test) for categorical measures and Kruskal–Wallis test for continuous measures.

Figure 2 Trajectories of serum AFP in intermediate-stage HCC patients after HR. Red dashed line = AFP value equaled to 25 ng/mL. Shadows = 95% confidence intervals. AFP=a-fetoprotein.

Figure 3 Kaplan-Meier curves of overall survival in patients with IM-HCC after HR.

Figure 4 Kaplan-Meier curves of disease-free survival in patients with IM-HCC after HR.

Table 2 Trajectory Classes of AFP and Multivariate HRs of Overall Survival with 95% CIs

	Event/N	Non-Adjusted	Adjust I*	Adjust II#
Low-stable	15/51	1	1	1
High-rising	27/52	3.00 (1.59, 5.68)	2.84 (1.50, 5.41)	2.84 (1.50, 5.41)
Sharp-falling	8/41	0.65 (0.28, 1.54)	0.59 (0.25, 1.40)	0.59 (0.25, 1.40)

Notes: *This model was adjusted of age. # This model was adjusted of age and AFP (<25, ≥25).

Figure 5 Relative importance of each risk factor for overall survival.

Abbreviations: AFP, alpha-fetoprotein; IM-HCC, intermediate-stage hepatocellular carcinoma; TACE, transarterial chemoembolization; OS, overall survival; DFS, disease-free survival; aHRs, adjusted hazard ratios; HCC, hepatocellular carcinoma; HR, hepatic resection; RFS, recurrence free survival; HBV, hepatitis B virus; HCV, hepatitis C virus.