Analysis of treatment outcome for lens culinaris agglutinin-reactive alpha-fetoprotein-positive hepatocellular carcinoma in relation to post-treatment disappearance of protein

Purpose: This study was designed to evaluate the influence of the rating “Lens culinaris agglutinin-reactive alphafetoprotein (AFP-L3) positive” on the outcome of treatment.Materials and methods: The study involved 232 patients with hepatocellular carcinoma rated as having liver damage class AB hepatopathy, a single tumor, tumor diameter 2 cm or smaller, no vascular invasion, and no extrahepatic lesion for whom AFP-L3 (“L3”) was measured at our hospital between 1994 and 2008. In these patients, the outcome of treatment was analyzed in relation to presence/absence (positive/negative) of L3 before treatment and post-treatment disappearance or persistence of L3 in pre-treatment L3-positive cases.Results: The cumulative survival rate was significantly lower for L3-positive cases than for L3-negative cases (p = 0.008). Neither the cumulative survival rate in L3-positive cases nor the post-treatment L3 disappearance rate in L3-positive cases before treatment differed significantly depending on the method of treatment (p = 0.7501, p = 0.3286). The cumulative survival rate was significantly higher for cases becoming L3 negative after treatment than for those failing to become L3-negative after treatment (p = 0.035).Conclusion: The prognosis was poorer in L3-positive cases than in L3-negative cases.Among L3-positive cases before treatment, the prognosis was poorer in cases failing to become L3-negative after treatment than in those becoming L3-negative after treatment.