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Lin HJ, Hsieh YH, Fang WL, et al. Clinical manifestations in patients with alpha-fetoprotein-producing gastric cancer. Curr Oncol. 2014;21(3):e394-9doi: 10.3747/co.21.1768.
Lin, H. J., Hsieh, Y. H., Fang, W. L., Huang, K. H., & Li, A. F. (2014). Clinical manifestations in patients with alpha-fetoprotein-producing gastric cancer. Current oncology (Toronto, Ont.), 21(3), e394-9. https://doi.org/10.3747/co.21.1768
Lin, H J, et al. "Clinical manifestations in patients with alpha-fetoprotein-producing gastric cancer." Current oncology (Toronto, Ont.) vol. 21,3 (2014): e394-9. doi: https://doi.org/10.3747/co.21.1768
Lin HJ, Hsieh YH, Fang WL, Huang KH, Li AF. Clinical manifestations in patients with alpha-fetoprotein-producing gastric cancer. Curr Oncol. 2014 Jun;21(3):e394-9. doi: 10.3747/co.21.1768. PMID: 24940098; PMCID: PMC4059802.
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Curr Oncol. 2014 Jun;21(3):e394-9. doi: 10.3747/co.21.1768.

Clinical manifestations in patients with alpha-fetoprotein-producing gastric cancer.

Current oncology (Toronto, Ont.)

H J Lin, Y H Hsieh, W L Fang, K H Huang, A F Y Li

Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei City, Taiwan. ; School of Medicine, Taipei Medical University, Taipei City, Taiwan.
  2. Division of Gastroenterology, Department of Medicine, Buddhist Dalin Tzu Chi General Hospital, Chia-Yi, Taiwan. ; Buddhist Tzu Chi University, School of Medicine, Hualien City, Taiwan.
  3. Division of General Surgery, Veterans General Hospital-Taipei, Taipei City, Taiwan. ; School of Medicine, National Yang-Ming University, Taipei City, Taiwan.
  4. School of Medicine, National Yang-Ming University, Taipei City, Taiwan. ; Department of Pathology, Veterans General Hospital-Taipei, Taipei City, Taiwan.

PMID: 24940098 PMCID: PMC4059802 DOI: 10.3747/co.21.1768

Abstract

BACKGROUND: Patients with alpha-fetoprotein (afp)-producing gastric cancer have a high incidence of liver metastasis and poor prognosis. There is some controversy about clinical manifestations in these patients.

METHODS: Our study enrolled patients who, before surgery, had gastric cancer with serum afp exceeding 20 ng/mL [afp>20 (n = 58)] and with serum afp 20 ng/mL or less [afp≤20 (n = 1236)]. Clinical manifestations were compared between the groups.

RESULTS: Early gastric cancer was more frequent (30.1% vs. 4%) and advanced gastric cancer was less frequent (69.9% vs. 96%) in the afp≤20 group than the afp>20 group (p < 0.001). Liver and lymph node metastasis occurred less frequently in the afp≤20 group (4.4% vs. 27.6%, p < 0.001, and 60.7% vs. 91.4%, p < 0.001, respectively). The 1-, 3-, 5-, and 10-year survival rates of afp≤20 patients were 75.2%, 53.4%, 45.8%, and 34.6% respectively. The 1-, 3-, 5-, and 10-year survival rates of patients with afp greater than 20 ng/mL, but 300 ng/mL or less, were 46.7%, 28.9%, 17.8%, and 13.3% respectively. The 1-, 3-, and 5-year survival rates of patients with serum afp greater than 300 ng/mL were 15.4%, 7.7%, and 0% respectively. The independent predictors for survival time were afp concentration, age, peritoneal seeding, liver metastasis, lymph node metastasis, vascular invasion, TNM stage, curative surgery, serosal invasion, and Lauren classification.

CONCLUSIONS: Patients with high serum afp had a high frequency of liver and lymph node metastasis and very poor prognosis. More aggressive management with multimodal therapy (for example, chemotherapy, radiotherapy) might be needed when treating such patients.

Keywords: Gastric cancer; alpha-fetoprotein; early gastric cancer; metastasis

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