The role of des-gamma carboxy-prothrombin (DCP) has been investigated in Asian countries, mainly Japan and South Korea, with the intent to improve the prognostic ability in the specific setting of liver transplantation (LT) and hepatic resection (HR) in patients with hepatocellular cancer (HCC).
However, only a limited number of studies has been published in western countries. Moreover, no information exists on the additive role of CDP and alpha-fetoprotein (AFP) as prognosticators of tumor aggressiveness. Recently, the model to predict tumor recurrence after living donor liver transplantation (MoRAL) score has been proposed in Korea, with the intent to investigate this specific field.
The aim of the present study is to investigate in a European setting the role of tumor-, liver- and inflammation-related markers as prognosticators of HCC aggressiveness, with particular attention to the combined role of AFP/DCP.
This is the first study focused on the combinative role of DCP and AFP in a European setting. Implementation in the use of DCP also in a European setting should represent a great innovation in the field of surgical oncology. The possibility to improve the diagnostic/prognostic ability before HCC treatment should, in fact, improve the capability to select patients at low-risk for recurrence, thus optimizing the surgical approach. A mathematical model constructed starting from the data of European patients should improve our ability to use a typical "Asian" tumor marker also in Europe, improving the quality of our management decision process.