Serum Insulin-Like Growth Factor-1 Level Is an Independent Predictor of Recurrence and Survival in Early Hepatocellular Carcinoma: A Prospective Cohort Study
Menée sur une cohorte de 101 patients atteints d'un carcinome hépatocellulaire de stade précoce et ayant reçu un traitement curatif, puis validée sur une cohorte de 91 autres patients, cette étude prospective montre que le niveau sérique d'IGF-1, mesuré avant le traitement, peut prédire le risque de récidive et la survie des patients, cela indépendamment des autres facteurs
Purpose: Insulin like-growth factor-1 (IGF-1) reflects hepatic synthetic function and plays an important role in the development and progression of various cancers. In this study, we investigated whether pretreatment serum IGF-1 levels predict time-to-recurrence (TTR) and overall survival (OS) in patients with early-stage hepatocellular carcinoma (HCC) after curative treatment.
Experimental Design : Consecutive HCC patients who had undergone surgical resection, radiofrequency ablation, or percutaneous ethanol injection as curative treatments of early HCC were included from two prospective cohorts and the training set (n=101) and the validation set (n=91) were established. Serum samples were collected before treatment and the levels of IGF-1 and IGF-binding protein-3 (IGFBP-3) were analyzed with regard to their associations with recurrence and survival. Results: In the training set, patients with low IGF-1 levels showed significantly shorter TTR (median, 14.6 months; 95% confidence interval [CI], 1.8-27.5) than patients with high IGF-1 levels (median, 50.8 months; 95% CI, 36.9-64.7; P<0.001) during a median follow-up period of 52.4 months. In the multivariate analysis, low levels of IGF-1 was an independent predictor of recurrence (hazard ratio [HR], 2.49; 95% CI, 1.52-4.08; P<0.001). Furthermore, together with high serum α-fetoprotein and multiple tumors, low levels of IGF-1 remained an independent predictor of poorer survival (HR, 8.00; 95% CI, 1.94-33.01; P=0.004). Applied to the independent validation set, low serum IGF-1 levels maintained its prognostic value for shorter TTR and OS. Conclusions: Low baseline IGF-1 levels independently correlated with shorter TTR and poorer survival in patients with early-stage HCC after curative treatment.
Clinical Cancer Research , résumé, 2013