Does very high alpha-fetoprotein affect very early hepatocellular carcinoma receiving hepatectomy?

Background: Following liver resection (LR), recurrence is critical to the prognosis of hepatocellular carcinoma (HCC). A higher level of alpha-fetoprotein (AFP) is typically associated with poor prognosis and recurrence concerns. Specifically, we attempted to determine whether high AFP (> 1,000ng/ml) and other potentially relevant factors affect survivals of patients with BCLC stage 0 HCC after LR. Methods: This retrospective study focused on 223 patients who received LR for stage 0 HCC of BCLC between 2004 and 2012. In patients with a low AFP (n = 200) and a high AFP (n = 23), we conducted chi-squares, independent t-test, Cox regression, and Kaplan–Meier survival analyses to investigate the relationship between clinicopathologic variables and outcomes. Results: The long-term disease-free survival (DFS) (p = 0.799) and the overall survival (OS) (p = 0.942) between the low and high AFP groups were comparable. The two groups' clinicopathologic features—tumor size, presence of a tumor capsule, cirrhosis, histology activity index (HAI), and microvascular invasion—appear to be similar. Additionally, we observed significant associations between HCC recurrence and ICG R15, HAI score, and cirrhosis, but not AFP. Conclusions: In stage 0 HCC, the consideration of curative-intent therapy in these patients should begin as soon as possible, irrespective of AFP levels.