Prognostic significance of serum insulin-like growth factor-1 in patients with hepatocellular carcinoma following transarterial chemoembolization.

Insulin-like growth factor-1 (IGF-1) is an effective survival factor that is involved in the development and progression of various tumors. The aim of the present study was to investigate whether baseline serum IGF-1 levels are associated with time to progression (TTP) and overall survival (OS) in patients with hepatocellular carcinoma (HCC) who have undergone transarterial chemoembolization (TACE). A total of 145 patients with HCC who underwent TACE as an initial treatment were enrolled in the study. Baseline serum IGF-1 levels were detected using enzyme-linked immunosorbent assay (ELISA) kits. The patients were followed up for a median follow-up period of 47 months (range, 10.6-69.3 months). During the follow-up, 98 patients (76.6%) experienced disease progression and 59 patients (46.1%) succumbed. The serum IGF-1 level was found to be significantly associated with hepatitis infection status, Child-Pugh class, bilirubin level, tumor size and nodularity, vascular invasion and the Barcelona Clinic Liver Cancer (BCLC) stage. Multivariate analysis was conducted, which indicated that BCLC stage, vascular invasion and serum IGF-1 were independent risk factors for disease progression. When clinical factors were examined as potential independent risk factors for OS, only advanced BCLC stage and low serum IGF-1 levels were found to be significantly associated with poorer OS. These results suggest that serum IGF-1 may serve as a predictor of the prognosis of patients with HCC undergoing TACE.