ABSTRACT

Background: Hepatocellular carcinoma or hepatoma accounts for most of the liver cancers. Transarterial embolization has increased the survival rates of patients with unresectable hepatoma. Alpha-fetoprotein has been undoubtedly widely used as a marker for the detection and monitoring of hepatocellular carcinoma.

Objective: To establish the relationship between serum alpha fetoprotein and tumor size in hepatocellular carcinoma patients at a tertiary care hospital before and after transarterial embolization.

Study Design: Cross-sectional retrospective study

Place and Duration of Study: Department of Gastroenterology, Rehman Medical Institute, Peshawar from 1st January 2015 to 31st December 2019.

Methodology: Thirty eight patients of hepatocellular carcinoma were enrolled. Individuals with a conclusive diagnosis of extrahepatic metastasis, other aggressive malignancies, complicated ascites, or the following laboratory abnormalities were excluded. The embolizing agent was chosen based on the agent's availability at the time of the treatment.

Results: The mean of the differences between pre and post treatment transarterial embolization levels were 272 in males and 196 in females. Mean of tumor burden was 9 in males and 5 in females. The mean maximum survival period on follow up was 76 days in males and 70 days in females. There was a positive difference between pre transarterial embolization alpha-fetoprotein levels and post transarterial embolization alpha-fetoprotein levels (P=0.024). Tumor burden and post transarterial embolization levels were significant at Pearson's value of 0.450 with P=0.005.

Conclusion: Trans arterial embolization with Polyvinyl alcohol embolization particles is effective in decreasing post-transarterial embolization alpha-fetoprotein levels, the difference between pre and post transarterial embolization alpha-fetoprotein levels depends upon tumor burden and pre-transarterial embolization alpha-fetoprotein levels. As there is a significant difference in AFP post procedure, further studies need to be conducted whether the drop in AFP post TAE has any survival benefits.

Keywords: Hepatocellular carcinoma (HCC), Alpha-fetoprotein (AFP), Polyvinyl alcohol, Prothrombin