1000 INDOCYANINE GREEN FLUORESCENCE INTRAOPERATIVE DETECTION: TOWARD A HIGHER CONCEPT OF SURGICAL RADICALITY

We divided the 348 patients into three groups according to the preoperative cutoff values of AFP (100ng/mL) and PIVKA-II (100 mAU/mL): both values low (Group I), one value high (Group II), and both values high (Group III). Results: The 1-, 3-, and 5-year overall survival (OS) rates of 348 patients were 87.8%, 75.3%, and 67.1%, respectively. The 1-, 3-, and 5-year disease-free survival (DFS) rates of 348 patients were 58.3%, 42.7%, and 37.3%, respectively. Ninety six patients (27.8%) died, and 192 patients (55.7%) had recurrence during follow-up period. Group I, II, and III were comprised of 126, 150, and 72 patients, respectively. The median AFP and PIVKA-II levels were 36.0 ng/mL (0.6–99,600) and 64.0 mAU/mL (0.5–2,000) at baseline. Univariate and subsequent multivariate analyses identified differences observed in OS among the groups (mean OS; Group I 83.2, Group II 75.3, Group III 59.4 months, HR 1.369, P =0.029) and in tumor size (HR 1.405, P =0.05). However there are no significant differences in DFS among the groups (P =0.064). Conclusion: Group I had the best OS in our study; Group II had a OS between I and III; and Group III the worst OS. Hence preoperative AFP and PIVKA-II measurement could be useful for predicting OS in HCC patients undergoing hepatectomy.