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Publications

Journal Article Epublish

PubMed: 42936266 DOI: 10.2147/JHC.S637289

Circulating Soluble EGFR Correlates with Tumor Burden and Hepatic Reserve but Lacks Independent Prognostic Value in Hepatocellular Carcinoma: A Prospective Turkish Cohort.

J Hepatocell Carcinoma 13:637289

Authors: Sahin Lacin, Rohat Esmer, Suayib Yalcin

Affiliations

  • Department of Medical Oncology, Koc University Hospital, Istanbul, Turkey.
  • School of Medicine, Koc University, Istanbul, Turkey.
  • Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey.

Abstract

PURPOSE

Serum soluble epidermal growth factor receptor (sEGFR) is a circulating extracellular-domain EGFR fragment that is biologically distinct from membrane-bound tissue EGFR, and its clinical meaning in hepatocellular carcinoma (HCC) has not been defined. We evaluated whether baseline serum sEGFR is related to tumor burden and hepatic reserve, and whether it carries prognostic information independent of established clinical variables.

PATIENTS AND METHODS

This prospective single-center cohort included 84 patients with HCC evaluated between November 2014 and May 2017. Baseline serum sEGFR was measured by ELISA. Overall survival (OS) was defined from baseline serum sample collection to death from any cause or last follow-up and was analyzed using Kaplan-Meier estimates, lg-rank testing, and Cox proportional hazards models with bootstrap internal validation. The incremental value of sEGFR over alpha-fetoprotein (AFP) and MELD-Na was tested in a combined model.

RESULTS

Lower serum sEGFR was associated with larger tumor size, higher AFP, higher aspartate aminotransferase and bilirubin levels, worse MELD-Na and Child-Turcotte-Pugh scores, lower insulin-like growth factor-1, and distant metastasis. Patients with sEGFR ≤13 ng/mL had shorter median OS than those with sEGFR >13 ng/mL (5.4 vs 12.1 months; log-rank p=0.0027; univariable HR 2.06, 95% CI 1.27-3.34). After adjustment for tumor size, log-transformed AFP, MELD-Na, portal vein thrombosis, and age, sEGFR was not associated with OS (HR 0.99, 95% CI 0.95-1.03, p=0.69), and the estimate remained close to the null across 1000 bootstrap resamples. Adding continuous sEGFR to a model containing AFP and MELD-Na did not improve discrimination (C-index 0.657 vs 0.656).

CONCLUSION

Low serum sEGFR identifies an adverse tumor-liver phenotype and shorter unadjusted survival, but it is not an independent prognostic factor and adds no discriminative information beyond AFP and MELD-Na. Serum sEGFR is best regarded as a marker of disease phenotype; it does not perform as a stand-alone prognostic test.

MeSH

Carcinoma, Hepatocellular, Growth, Serum, Neoplasms, Phenotype, Tumor Burden