Actual Half-Life of Alpha-Fetoprotein as a Prognostic Tool in Pediatric Malignant Tumors

ABSTRACT

In a retrospective study, the prognostic value of monitoring the decay of alpha-fetoprotein (AFP) was assessed. Serum AFP was determined serially in 18 children with malignant germ cell tumors or malignant hepatic tumors Fifteen children had malignant germ cell tumors (endodermal sinus tumor;7, embryonal carcinoma;3, malignant teratoma;5). Two children had hepatoblastoma and a third had hepatocellular carcinoma. The actual half-life (AHL) of AFP was computed according to the formula after the surgical resection of the tumor. In group 1, which had a complete resection and no recurrence during follow-up (n=13), the AHL of AFP was 4.0+/-0.9 days. In group 2, which had a incomplete resection or recurrence during follow-up (n=5), the AHL of AFP was 24.8+/-20 days. The AHL of group 2 was significantly longer than that of group 1 (p = 0.0026). The increased AHL of AFP indicated the residual active tumor after surgical resection. The AHL of AFP may be more sensitive than the serial monitoring of AFP in detecting the preclinical recurrence after surgical resection of AFP secreting tumors. Treatment strategies can be based on AFP clearance and prospective clinical trials are warranted.