4%) had an extremely high (>400 ng/mL) serum alpha-fetoprotein level. Treatment of HCC was liver transplantation in three selleck kinase inhibitor patients

(1.5%), hepatic resection in 53 patients (25.8%), RFTA and PEI in 66 (32.2%) and 83 (40.5%) patients, respectively. Median duration of follow-up was 3.7 years, and median time to death was 48 months. Figure 1 shows the log-transformed serum alpha-fetoprotein levels in the 205 patients subdivided according to status (survivors and deceased). Among the 180 patients with viral etiology of liver disease, 154 patients (85.6%) had chronic hepatitis C virus (HCV) infection (including four patients with chronic HCV-HBV coinfection), and 26 patients (14.4%) had chronic HBV infection alone. All in all, 47 patients had been treated with interferon-based antiviral therapy before HCC diagnosis (41 HCV-positive alone,

4 HBV-positive alone, and 2 with HCV-HBV coinfection). Among HBV patients, seven were being treated with nucleos(t)ide analogs at the time of HCC diagnosis. We subdivided AG-014699 mouse viral patients into two groups—those with current and past antiviral therapy (n = 50) versus those who received no antiviral therapy at all (n = 104)—and evaluated alpha-fetoprotein levels in these two groups. The median alpha-fetoprotein level was 19.5 ng/mL (range, 2.0-4,185 ng/mL) and 16.0 ng/mL (range, 1.0-1,600 ng/mL), respectively (P = 0.874). Table 2 shows the main demographic and clinical characteristics of the patients subdivided according to alpha-fetoprotein levels (≤20 ng/mL; 21-200 ng/mL; >200 ng/mL). Among the parameters evaluated, female gender (P = 0.007) and greater increase in alanine aminotransferase (P = 0.011) were significantly more common in patients with mildly (21-200 ng/mL) or markedly elevated (>200 ng/mL) alpha-fetoprotein levels. HCC diameter and degree of liver failure were not significantly different among the three alpha-fetoprotein classes. Modality of HCC treatment (surgical versus ablation, P = 0.444) and causes medchemexpress of death were similar

among the three groups. Edmondson grading was available only in a minority of patients in all classes (27% in patients with alpha-fetoprotein ≤20 ng/mL; 17% in patients with alpha-fetoprotein 21-200 ng/mL; 11% in patients with alpha-fetoprotein >200 ng/mL). Despite this limitation, patients with well and moderately differentiated HCCs tended to be more frequently observed in the group with normal (≤20 ng/mL) or mildly elevated (21-200 ng/mL) alpha-fetoprotein levels (P = 0.056). During the follow-up, 96 patients (46.8%) died and the proportion of deceased patients was similar in the three alpha-fetoprotein classes (≤20 ng/mL; 21-200 ng/mL; >200 ng/mL). Similarly, the causes of death were not different across the three alpha-fetoprotein classes. Figure 2 shows the actuarial survival curves of these patients. There was no statistically significant difference among the three alpha-fetoprotein classes (χ2 = 1.4162, P = 0.493).