AFP as an HCC surveillance tool detects a significant number of treatable HCC in patients with satisfactory outcomes.

Abstract

<p><b>A</b>) Survival for total HCC cohort diagnosed with HCC between 1/1/2009 and 31/12/2014. <b>B</b>) The role of AFP in HCC detection. Method of HCC detection for the 133 patients within HCC surveillance programme at the time of diagnosis, chequered area within AFP pickup group represents the 28/49 patients in whom a recent US had not been performed—see text for details. <b>C</b>) Individual AFP levels at time of diagnosis for patients diagnosed with HCC, AFP values plotted at log10; AFP = 6 (local ULN; yellow) and AFP = 20 (red) are shown. All columns p<0.0001 to one another by Kruskal Wallis test with Dunns multiple comparison. <b>D</b>) Survival of patients with HCC diagnosed through surveillance screening either through US or AFP mediated conversion to CT/MRI imaging, error bars = SEM, p value denotes Mantel Cox. <b>E</b>) Therapy offered to patients within each group (US detected n = 61 and AFP detected n = 49) of patients with HCC detected during surveillance; all p>0.05 by 2 way Anova. Of the 11 and 9 patients listed for liver transplantation, 2 (due to tumour growth) and 1 (due to frailty) were delisted from the waiting list whilst awaiting transplantation in US and AFP detected groups respectively.</p