Alpha-Fetoprotein Response after First Transarterial Chemoembolization (TACE) and Complete Pathologic Response in Patients with Hepatocellular Cancer
Transarterial chemoembolization (TACE) is used as a bridging treatment in liver transplant candidates with hepatocellular carcinoma (HCC). Alpha-fetoprotein (AFP) is the main tumor marker used for HCC surveillance. The aim of this study was to assess the potential of using the AFP change after the f...
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| Veröffentlicht in: | Cancers 2023-08, Vol.15 (15), p.3962 |
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| creator | Masior, Łukasz Krasnodębski, Maciej Kuncewicz, Mikołaj Karaban, Kacper Jaszczyszyn, Igor Kruk, Emilia Małecka-Giełdowska, Milena Korzeniowski, Krzysztof Figiel, Wojciech Krawczyk, Marek Wróblewski, Tadeusz Grąt, Michał |
| description | Transarterial chemoembolization (TACE) is used as a bridging treatment in liver transplant candidates with hepatocellular carcinoma (HCC). Alpha-fetoprotein (AFP) is the main tumor marker used for HCC surveillance. The aim of this study was to assess the potential of using the AFP change after the first TACE in the prediction of complete tumor necrosis. The study comprised 101 patients with HCC who underwent liver transplantation (LT) after TACE in the period between January 2011 and December 2020. The ΔAFP was defined as the difference between the AFP value before the first TACE and AFP either before the second TACE or the LT. The receiver operator characteristics (ROC) curves were used to identify an optimal cut-off value. Complete tumor necrosis was found in 26.1% (18 of 69) and 6.3% (2 of 32) of patients with an initial AFP level under and over 100 ng/mL, respectively (
= 0.020). The optimal cut-off value of ΔAFP for the prediction of complete necrosis was a decline of ≥10.2 ng/mL and ≥340.5 ng/mL in the corresponding subgroups. Complete tumor necrosis rates were: 62.5% (5 of 8) in patients with an initial AFP < 100 ng/mL and decline of ≥10.2 ng/mL; 21.3% (13 of 61) in patients with an initial AFP < 100 ng/mL and decline of 100 ng/mL and decline of ≥340.5 ng/mL; and null in 20 patients with an initial AFP > 100 ng/mL and decline of |
| doi_str_mv | 10.3390/cancers15153962 |
| format | Article |
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= 0.020). The optimal cut-off value of ΔAFP for the prediction of complete necrosis was a decline of ≥10.2 ng/mL and ≥340.5 ng/mL in the corresponding subgroups. Complete tumor necrosis rates were: 62.5% (5 of 8) in patients with an initial AFP < 100 ng/mL and decline of ≥10.2 ng/mL; 21.3% (13 of 61) in patients with an initial AFP < 100 ng/mL and decline of <10.2 ng/mL; 16.7% (2 of 12) in patients with an initial AFP > 100 ng/mL and decline of ≥340.5 ng/mL; and null in 20 patients with an initial AFP > 100 ng/mL and decline of <340.5 ng/mL, respectively (
= 0.003). The simple scoring system, based on the initial AFP and AFP decline after the first treatment, distinguished between a high, intermediate and low probability of complete necrosis, with an area under the ROC curve of 0.699 (95% confidence intervals 0.577 to 0.821,
= 0.001). Combining the initial AFP with its change after the first treatment enables early identification of the efficacy of TACE.</description><identifier>ISSN: 2072-6694</identifier><identifier>EISSN: 2072-6694</identifier><identifier>DOI: 10.3390/cancers15153962</identifier><identifier>PMID: 37568778</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Cancer ; Cancer patients ; Care and treatment ; Confidence intervals ; Glycoproteins ; Hepatocellular carcinoma ; Liver ; Liver cancer ; Liver transplantation ; Liver transplants ; Medical prognosis ; Medical research ; Medicine, Experimental ; Morphology ; Necrosis ; Predictions ; Transplantation ; Tumor markers ; Tumors ; α-Fetoprotein</subject><ispartof>Cancers, 2023-08, Vol.15 (15), p.3962</ispartof><rights>COPYRIGHT 2023 MDPI AG</rights><rights>2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 by the authors. 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c443t-110a8e30c79644b5b82209008ec15f68a76892af16178f3afcfb8da8bffe0ed93</cites><orcidid>0000-0002-5291-749X ; 0009-0003-3405-0372 ; 0009-0006-0110-3505 ; 0000-0003-3372-3072 ; 0000-0002-6234-615X ; 0009-0002-0116-9919</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10417598/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10417598/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37568778$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Masior, Łukasz</creatorcontrib><creatorcontrib>Krasnodębski, Maciej</creatorcontrib><creatorcontrib>Kuncewicz, Mikołaj</creatorcontrib><creatorcontrib>Karaban, Kacper</creatorcontrib><creatorcontrib>Jaszczyszyn, Igor</creatorcontrib><creatorcontrib>Kruk, Emilia</creatorcontrib><creatorcontrib>Małecka-Giełdowska, Milena</creatorcontrib><creatorcontrib>Korzeniowski, Krzysztof</creatorcontrib><creatorcontrib>Figiel, Wojciech</creatorcontrib><creatorcontrib>Krawczyk, Marek</creatorcontrib><creatorcontrib>Wróblewski, Tadeusz</creatorcontrib><creatorcontrib>Grąt, Michał</creatorcontrib><title>Alpha-Fetoprotein Response after First Transarterial Chemoembolization (TACE) and Complete Pathologic Response in Patients with Hepatocellular Cancer</title><title>Cancers</title><addtitle>Cancers (Basel)</addtitle><description>Transarterial chemoembolization (TACE) is used as a bridging treatment in liver transplant candidates with hepatocellular carcinoma (HCC). Alpha-fetoprotein (AFP) is the main tumor marker used for HCC surveillance. The aim of this study was to assess the potential of using the AFP change after the first TACE in the prediction of complete tumor necrosis. The study comprised 101 patients with HCC who underwent liver transplantation (LT) after TACE in the period between January 2011 and December 2020. The ΔAFP was defined as the difference between the AFP value before the first TACE and AFP either before the second TACE or the LT. The receiver operator characteristics (ROC) curves were used to identify an optimal cut-off value. Complete tumor necrosis was found in 26.1% (18 of 69) and 6.3% (2 of 32) of patients with an initial AFP level under and over 100 ng/mL, respectively (
= 0.020). The optimal cut-off value of ΔAFP for the prediction of complete necrosis was a decline of ≥10.2 ng/mL and ≥340.5 ng/mL in the corresponding subgroups. Complete tumor necrosis rates were: 62.5% (5 of 8) in patients with an initial AFP < 100 ng/mL and decline of ≥10.2 ng/mL; 21.3% (13 of 61) in patients with an initial AFP < 100 ng/mL and decline of <10.2 ng/mL; 16.7% (2 of 12) in patients with an initial AFP > 100 ng/mL and decline of ≥340.5 ng/mL; and null in 20 patients with an initial AFP > 100 ng/mL and decline of <340.5 ng/mL, respectively (
= 0.003). The simple scoring system, based on the initial AFP and AFP decline after the first treatment, distinguished between a high, intermediate and low probability of complete necrosis, with an area under the ROC curve of 0.699 (95% confidence intervals 0.577 to 0.821,
= 0.001). Combining the initial AFP with its change after the first treatment enables early identification of the efficacy of TACE.</description><subject>Cancer</subject><subject>Cancer patients</subject><subject>Care and treatment</subject><subject>Confidence intervals</subject><subject>Glycoproteins</subject><subject>Hepatocellular carcinoma</subject><subject>Liver</subject><subject>Liver cancer</subject><subject>Liver transplantation</subject><subject>Liver transplants</subject><subject>Medical prognosis</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Morphology</subject><subject>Necrosis</subject><subject>Predictions</subject><subject>Transplantation</subject><subject>Tumor markers</subject><subject>Tumors</subject><subject>α-Fetoprotein</subject><issn>2072-6694</issn><issn>2072-6694</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptkl9vFCEUxSdGY5vaZ98MiS_1YVsYZoB5MptJa02aaMz6PLnDXnZpGBiB1ej38PvK2tp_ER4gl985cMitqteMnnLe0TMNXmNMrGUt70T9rDqsqawXQnTN8wf7g-o4pWtaBudMCvmyOuCyFUpKdVj9Xrp5C4sLzGGOIaP15AumOfiEBEzGSC5sTJmsIvgEsRQsONJvcQo4jcHZX5Bt8ORktezP3xHwa9KHaXaYkXyGvA0ubKy-9yz-pWzR50R-2LwllzhDDhqd2zmIpP-b6VX1woBLeHy7HlVfL85X_eXi6tOHj_3yaqGbhucFYxQUcqplJ5pmbEdV17SjVKFmrREKpFBdDYYJJpXhYLQZ1RrUaAxSXHf8qHp_4zvvxgnXujwrghvmaCeIP4cAdnh84u122ITvA6MNk22nisPJrUMM33aY8jDZtE8DHsMuDbVqKWeqaduCvn2CXodd9CVfoRrVybrj8p7agMPBehPKxXpvOiyloC1raiUKdfofqsw1TlYHj8aW-iPB2Y1Ax5BSRHMXktFh303Dk24qijcP_-aO_9c7_A9uL8iS</recordid><startdate>20230804</startdate><enddate>20230804</enddate><creator>Masior, Łukasz</creator><creator>Krasnodębski, Maciej</creator><creator>Kuncewicz, Mikołaj</creator><creator>Karaban, Kacper</creator><creator>Jaszczyszyn, Igor</creator><creator>Kruk, Emilia</creator><creator>Małecka-Giełdowska, Milena</creator><creator>Korzeniowski, Krzysztof</creator><creator>Figiel, Wojciech</creator><creator>Krawczyk, Marek</creator><creator>Wróblewski, Tadeusz</creator><creator>Grąt, Michał</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7TO</scope><scope>7XB</scope><scope>8FE</scope><scope>8FH</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-5291-749X</orcidid><orcidid>https://orcid.org/0009-0003-3405-0372</orcidid><orcidid>https://orcid.org/0009-0006-0110-3505</orcidid><orcidid>https://orcid.org/0000-0003-3372-3072</orcidid><orcidid>https://orcid.org/0000-0002-6234-615X</orcidid><orcidid>https://orcid.org/0009-0002-0116-9919</orcidid></search><sort><creationdate>20230804</creationdate><title>Alpha-Fetoprotein Response after First Transarterial Chemoembolization (TACE) and Complete Pathologic Response in Patients with Hepatocellular Cancer</title><author>Masior, Łukasz ; Krasnodębski, Maciej ; Kuncewicz, Mikołaj ; Karaban, Kacper ; Jaszczyszyn, Igor ; Kruk, Emilia ; Małecka-Giełdowska, Milena ; Korzeniowski, Krzysztof ; Figiel, Wojciech ; Krawczyk, Marek ; Wróblewski, Tadeusz ; Grąt, Michał</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c443t-110a8e30c79644b5b82209008ec15f68a76892af16178f3afcfb8da8bffe0ed93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Cancer</topic><topic>Cancer patients</topic><topic>Care and treatment</topic><topic>Confidence intervals</topic><topic>Glycoproteins</topic><topic>Hepatocellular carcinoma</topic><topic>Liver</topic><topic>Liver cancer</topic><topic>Liver transplantation</topic><topic>Liver transplants</topic><topic>Medical prognosis</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Morphology</topic><topic>Necrosis</topic><topic>Predictions</topic><topic>Transplantation</topic><topic>Tumor markers</topic><topic>Tumors</topic><topic>α-Fetoprotein</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Masior, Łukasz</creatorcontrib><creatorcontrib>Krasnodębski, Maciej</creatorcontrib><creatorcontrib>Kuncewicz, Mikołaj</creatorcontrib><creatorcontrib>Karaban, Kacper</creatorcontrib><creatorcontrib>Jaszczyszyn, Igor</creatorcontrib><creatorcontrib>Kruk, Emilia</creatorcontrib><creatorcontrib>Małecka-Giełdowska, Milena</creatorcontrib><creatorcontrib>Korzeniowski, Krzysztof</creatorcontrib><creatorcontrib>Figiel, Wojciech</creatorcontrib><creatorcontrib>Krawczyk, Marek</creatorcontrib><creatorcontrib>Wróblewski, Tadeusz</creatorcontrib><creatorcontrib>Grąt, Michał</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cancers</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Masior, Łukasz</au><au>Krasnodębski, Maciej</au><au>Kuncewicz, Mikołaj</au><au>Karaban, Kacper</au><au>Jaszczyszyn, Igor</au><au>Kruk, Emilia</au><au>Małecka-Giełdowska, Milena</au><au>Korzeniowski, Krzysztof</au><au>Figiel, Wojciech</au><au>Krawczyk, Marek</au><au>Wróblewski, Tadeusz</au><au>Grąt, Michał</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Alpha-Fetoprotein Response after First Transarterial Chemoembolization (TACE) and Complete Pathologic Response in Patients with Hepatocellular Cancer</atitle><jtitle>Cancers</jtitle><addtitle>Cancers (Basel)</addtitle><date>2023-08-04</date><risdate>2023</risdate><volume>15</volume><issue>15</issue><spage>3962</spage><pages>3962-</pages><issn>2072-6694</issn><eissn>2072-6694</eissn><abstract>Transarterial chemoembolization (TACE) is used as a bridging treatment in liver transplant candidates with hepatocellular carcinoma (HCC). Alpha-fetoprotein (AFP) is the main tumor marker used for HCC surveillance. The aim of this study was to assess the potential of using the AFP change after the first TACE in the prediction of complete tumor necrosis. The study comprised 101 patients with HCC who underwent liver transplantation (LT) after TACE in the period between January 2011 and December 2020. The ΔAFP was defined as the difference between the AFP value before the first TACE and AFP either before the second TACE or the LT. The receiver operator characteristics (ROC) curves were used to identify an optimal cut-off value. Complete tumor necrosis was found in 26.1% (18 of 69) and 6.3% (2 of 32) of patients with an initial AFP level under and over 100 ng/mL, respectively (
= 0.020). The optimal cut-off value of ΔAFP for the prediction of complete necrosis was a decline of ≥10.2 ng/mL and ≥340.5 ng/mL in the corresponding subgroups. Complete tumor necrosis rates were: 62.5% (5 of 8) in patients with an initial AFP < 100 ng/mL and decline of ≥10.2 ng/mL; 21.3% (13 of 61) in patients with an initial AFP < 100 ng/mL and decline of <10.2 ng/mL; 16.7% (2 of 12) in patients with an initial AFP > 100 ng/mL and decline of ≥340.5 ng/mL; and null in 20 patients with an initial AFP > 100 ng/mL and decline of <340.5 ng/mL, respectively (
= 0.003). The simple scoring system, based on the initial AFP and AFP decline after the first treatment, distinguished between a high, intermediate and low probability of complete necrosis, with an area under the ROC curve of 0.699 (95% confidence intervals 0.577 to 0.821,
= 0.001). Combining the initial AFP with its change after the first treatment enables early identification of the efficacy of TACE.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>37568778</pmid><doi>10.3390/cancers15153962</doi><orcidid>https://orcid.org/0000-0002-5291-749X</orcidid><orcidid>https://orcid.org/0009-0003-3405-0372</orcidid><orcidid>https://orcid.org/0009-0006-0110-3505</orcidid><orcidid>https://orcid.org/0000-0003-3372-3072</orcidid><orcidid>https://orcid.org/0000-0002-6234-615X</orcidid><orcidid>https://orcid.org/0009-0002-0116-9919</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Cancers, 2023-08, Vol.15 (15), p.3962 |
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| source | MDPI - Multidisciplinary Digital Publishing Institute; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; PubMed Central Open Access |
| subjects | Cancer Cancer patients Care and treatment Confidence intervals Glycoproteins Hepatocellular carcinoma Liver Liver cancer Liver transplantation Liver transplants Medical prognosis Medical research Medicine, Experimental Morphology Necrosis Predictions Transplantation Tumor markers Tumors α-Fetoprotein |
| title | Alpha-Fetoprotein Response after First Transarterial Chemoembolization (TACE) and Complete Pathologic Response in Patients with Hepatocellular Cancer |
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