Abstract 205P
Background
HCC is an uncontrolled malignant proliferation of hepatocytes occurring in 2%-3% in US Patients with liver Cirrhosis. Alfa fetoprotein (AFP) has a prognostic value in small HCC survival. Some studies discussed the role of AFP in small sized HCC lesions, but there are no enough evidence supporting the role of AFP in unresectable HCC. So the aim of this study was to evaluate the survival outcome of elevated AFP level in unresectable HCC larger than 10 cm.
Methods
Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database for HCC patients diagnosed from 2000 to 2020. Patients were grouped according to the age young and middle aged if <65 years and elderly if >65 years. The unresectable HCC was grouped according to the site: size 10-15 cm and more than 15 cm. We excluded patients with unknown AFP. SPSS version 27 was used for data analysis, Kaplan-Meier curve and Log-Rank test were used for survival analysis.
Results
Out of 3534 HCC patients, the majority had elevated AFP level (80%). Unresectable HCC had 3-year and 5-year relative survival of 11.0% and 7.8%. Negative AFP had better 5-year relative survival compared to patients with elevated AFP (17.6% and 5.3%, P>0.001(. The 5-year relative survival for males and females was quite similar in negative AFP (16.8% and 20.6%; P= 0.53) while females had improved survival outcome when AFP was positive (9% and 4.5%; P<0.001). In the group with negative AFP, the 5-year relative survival for the young and middle aged was 21.1% and 13.6% for the elderly (P= 0.012) while in positive AFP, the young and middle aged had limited survival benefit compared to the elderly but statistically significant (4.5% and 6.6%, P= 0.012). Regarding the lesion size, negative AFP had 5-year relative survival of 16.5% and 20.9% in both size groups: 10-15 cm and more than 15 cm (P=0.16) while positive AFP had survival of 5.6% and 4.6% respectively) P=0.09).
Conclusions
HCC larger than 10 cm has very poor survival outcome across all age groups regardless the size. Elevated AFP is associated with worse survival outcome in unresectable HCC with diminished survival by 12%. These results highlight AFP as an essential prognostic factor in unrespectable HCC.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.