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      Favorable Impact of Serum TERT C228T for Prognosis after Surgical Resection for Liver Cancer

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          Abstract

          Introduction: Personalized medicine and molecular therapies with the diagnosis of somatic genetic alterations are expected to be developed for liver cancer. Nevertheless, it is unknown whether a mutation in the telomere reverse transcriptase promoter (TERT C228T) in serum cfDNA might be useful for making prognostic predictions after surgical resection for primary liver cancer. Methods: This cohort study retrospectively investigated 111 patients who had undergone surgical resection of liver cancer for the first time. We investigated the differences between clinicopathological features and prognosis according to classification of three tumor markers, including AFP, PIVKAII, and TERT C228T. Results: Multivariate analysis identified etiology (fatty liver disease vs. HBV odds ratio [OR] 6.853) and fibrosis stage (2–4, OR: 0.137) as determinants of TERT C228T-positive liver cancer with normal levels of AFP and PIVKAII (TERT single positive liver cancer). TERT single positive (Yes, OR: 0.301), fibrosis (FIB)-4 index (≥3.25, OR: 2.038), Child-Pugh classification (B, OR: 4.975), and number of tumors (≥2, OR: 4.098) were identified as determinants of the recurrence of liver cancer. TERT single positive (Yes, OR: 3.311), FIB-4 index (≥3.25, OR: 0.433), and number of tumors (≥2, OR: 0.262) were identified as determinants of disease-free survival. Conclusions: Our results highlight the impact of classification of prognostic tumor markers. TERT single positive is one predictor of favorable prognosis after surgical resection for liver cancer.

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          Author and article information

          Journal
          OCL
          Oncology
          10.1159/issn.0030-2414
          Oncology
          Oncology
          S. Karger AG
          0030-2414
          1423-0232
          2023
          October 2023
          31 August 2023
          : 101
          : 11
          : 738-752
          Affiliations
          [_a] aDepartment of Hepatology, Toranomon Hospital and Okinaka Memorial Institute for Medical Research, Tokyo, Japan
          [_b] bLiver Research Laboratory, Toranomon Hospital, Tokyo, Japan
          Article
          533303 Oncology 2023;101:738–752
          10.1159/000533303
          37651985
          7503aed1-2cca-4e1a-9d0d-a15684ea871a
          © 2023 The Author(s). Published by S. Karger AG, Basel

          This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission.

          History
          : 20 April 2023
          : 07 July 2023
          Page count
          Figures: 8, Tables: 5, Pages: 15
          Funding
          This study was supported in part by Grant-in-Aid from the Japan Agency for Medical Research and Development (JP23fk0210090, JP23fk0210113, JP23fk0210129), Ministry of Health, Labour and Welfare (20HC2003), and the Japanese Society of Gastroenterology (JSGE) Grant.
          Categories
          Clinical Translational Research

          Medicine
          Disease-free survival, TERT promoter,Alpha fetoprotein,PIVKAII,Surgical resection
          Medicine
          Disease-free survival, TERT promoter, Alpha fetoprotein, PIVKAII, Surgical resection

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