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Prognostic Significance of Elevated Preoperative Serum CA125 Levels After Curative Hepatectomy for Hepatocellular Carcinoma

Authors Huang Y, Zeng J, Liu T, Lin X, Guo P, Zeng J, Zhou W, Liu J

Received 29 October 2019

Accepted for publication 7 May 2020

Published 22 May 2020 Volume 2020:13 Pages 4559—4567

DOI https://doi.org/10.2147/OTT.S236475

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Jianmin Xu


Yao Huang,1– 3 Jianxing Zeng,2,4 Teng Liu,2 Xinju Lin,2 Pengfei Guo,4 Jinhua Zeng,1– 3 Weiping Zhou,5 Jingfeng Liu1– 4

1Department of Hepatobiliary Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, People’s Republic of China; 2Department of Hepatic Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou 350025, People’s Republic of China; 3The Liver Center of Fujian Province, Fujian Medical University, Fuzhou 350025, People’s Republic of China; 4Southeast Big Data Institute of Hepatobiliary Health, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou 350025, People’s Republic of China; 5The Third Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, People’s Republic of China

Correspondence: Jingfeng Liu
Department of Hepatobiliary Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, People’s Republic of China
Tel/ Fax +86 591 8370 5927
Email drjingfeng@126.com

Objective: The aim of this study was to investigate predictive and prognostic significance of elevated carbohydrate antigen 125 (CA125) serum level preoperatively.
Methods: A total of 3440 HCC patients were retrospectively enrolled into this study, and all of them underwent curative hepatectomy. The clinical and pathological variables together with CA125, AFP serum level were collected at diagnosis and postoperative care stages. A chi-square test was used to compare the differences between variables. Overall survival (OS) and recurrence-free survival (RFS) were measured with the Kaplan–Meier method. To estimate prognostic factors, a multivariate Cox regression analysis was performed.
Results: Of the 3440 enrolled patients, 409 (11.9%) exhibited elevated preoperative serum CA125 level, and high preoperative serum CA125 level was significantly associated with younger age, female, higher ALBI grade, higher serum AFP level, blood transfusion, more operative bleeding loss, larger tumor size, multiple tumor, increased macro- or micro-vascular invasion, Edmondson grade III–IV, absence of tumor capsular, satellite nodules, liver cirrhosis, more advanced TNM stages and BCLC stages. HCC patients with high preoperative serum CA125 level usually had a shorter OS rate and experienced a higher probability of recurrence than those with normal preoperative serum level of CA125 (p< 0.0001). The multivariate analysis suggested that elevated serum CA125 level serves as an independent predictor of OS and RFS in HCC patients after surgical resection.
Conclusion: Elevated preoperative serum CA125 correlated with many malignant characterizations of HCC and served as an independent prognostic factor of OS and RFS.

Keywords: CA125, hepatocellular carcinoma, prognosis, hepatectomy

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