Postoperative serum alpha-fetoprotein level is a useful predictor of recurrence after hepatectomy for hepatocellular carcinoma.

We evaluated the clinical value of perioperative alpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) levels in predicting recurrence of hepatocellular carcinoma (HCC) after curative resection, with a focus on the time course as surveillance tools. A total of 165 consecutive HCC patients who had undergone curative hepatectomy at our institution from 2005 to 2007 and whose serum AFP and DCP had been measured before and after hepatectomy were included in this study. The minimum postoperative levels within a 4-month period were used for analysis. Among the patients with a positive level of AFP before operation, the number of patients whose AFP level did not change from positive to negative after operation in the group with recurrence exceeded that in the group without recurrence (48/60, 80.0% vs. 4/23, 17.4%), and the difference was significant (P<0.001). Minimum postoperative AFP level was found to be a significant independent risk factor for recurrence by multivariate analysis (P<0.001). There was no statistically significant correlation between AFP level and grade of hepatitis activity (P=0.599). Postoperative AFP level is a useful tool for predicting recurrence after curative hepatectomy. A positive level of AFP after operation might suggest a site of residual viable cancer. The need for effective adjuvant therapy and close follow-up is suggested in patients with a positive postoperative AFP level.