The Half-Life of Serum Des-Gamma-Carboxy Prothrombin Is a Prognostic Index of Survival and Recurrence After Liver Resection for Hepatocellular Carcinoma.

Abstract

Des-γ-carboxy prothrombin (DCP) is a representative tumor marker of hepatocellular carcinoma (HCC), and its values are occasionally very high in HCC cases. The current study aimed to clarify the postoperative half-life of DCP as a prognostic factor. This retrospective study enrolled 177 patients who had undergone liver resection as an initial treatment for HCC. Three DCP half-life groups were defined as follows: within the normal range, half-life shorter than 4 days, and half-life of 4 days or longer. The overall and recurrence-free survival rates were estimated and compared among the three groups. There were 140 patients in the group with a DCP half-life in the normal range, 19 patients in the group with a DCP half-life shorter 4 days, and 18 patients in the group with a DCP half-life of 4 days or longer. A multivariate analysis showed that only a postoperative DCP half-life of 4 days or longer was an independent prognostic risk factor for overall and recurrence-free survival (respective hazard ratios of 2.92 and 4.19; P < 0.001). The group with a preoperative DCP value lower than 1400 mAU/mL, the median value of DCP in the current study, included no patients from the group with a half-life shorter than 4 days. The overall and recurrence-free survival rates in the group with a half-life of 4 days or longer were significantly poorer (P < 0.001) than in the group that had a half-life shorter than 4 days (P = 0.002) with a preoperative DCP status of 1400 mAU/mL or more. The current study showed for the first time that a prolonged half-life of DCP is an independent prognostic risk factor for survival and recurrence after liver resection with curative intent.