The significance of serum AFP cut-off values, 20 and 400 ng/mL in curatively resected patients with hepatocellular carcinoma and cirrhosis might be of difference.

Background/aims: The significance of preoperative serum a-fetoprotein (AFP) level in hepatocellular carcinoma (HCC) treated with different modalities remains controversial. Besides, many cut-off values have been used. The present study aims to clarify significance of two major ones in HCC with cirrhosis.

Methodology: One hundred and thirty eight consecutive cirrhotic patients with HCC after curative resection are included. The correlations between serum AFP level and clinicopathological parameters and patient survival are evaluated and compared when 400ng/mL and 20ng/mL are set as cut-off points.

Results: Serum AFP level is associated with more clinicopathological variables of HCC under the cut-off value of 400ng/mL, than that of 20ng/ mL. However, serum AFP level under the cut-off value of 20ng/mL is of significant prognostic impact for both overall and tumor-free survival, whereas that under 400ng/mL is not.

Conclusions: The two cut-off values of preoperative AFP levels might be of different implications in cirrhotic patients with HCC after curative resection. Therefore, these might be adopted differentially in HCC.