Antiviral Therapy Inhibited HBV-reactivation and Improved Long-term Outcomes in Patients Who Underwent Radiofrequency Ablation for HBV-related Hepatocellular Carcinoma

Abstract

Background: The study aimed to examine the impact of antiviral therapy (AVT) on hepatitis B virus (HBV) reactivation and long-term outcomes after percutaneous radiofrequency ablation (PRFA) for HBV-related hepatocellular carcinoma (HCC). Methods: Data on 538 consecutive patients who underwent PRFA for early-stage HBV-related HCC between 2009 and 2013 were reviewed. Propensity score matching (PSM) analysis was used to adjust for differences in baseline features between AVT and non-AVT groups. Tumor recurrence and overall survival (OS) rates were analyzed using the Kaplan-Meier method. Tumor recurrence patterns were also investigated. Logistic regression was used to identify the risk factors of viral reactivation. Results: After PSM, 215 pairs of patients were generated. The AVT group had a lower 1-, 3-, and 5-year tumor recurrence rates (24%, 55%, and 67% vs 33%, 75%, and 85%, respectively) and a higher 1-, 3-, and 5-year OS rates (100%, 67%, and 59% vs 100%, 52%, and 42%, respectively) than non-AVT group (P<0.001 for both). Additionally, the intrahepatic distant recurrence and the later recurrence beyond 2 years after PRFA were significantly reduced in the AVT group compared with the non-AVT group (111/215 vs. 78/215, P=0.001; 39/109 vs. 61/91, P=0.012, respectively). HBV reactivation developed in 10.8% of patients after PRFA. AVT was identified as one of the independent risk factors of viral reactivation (odd ratio: 0.061, 95% confidence interval: 0.018-0.200). Conclusions: AVT reduced recurrence rate and improved OS of HBV-related HCC patients undergoing PRFA, possibly by inhibiting viral reactivation and then decreasing intrahepatic distant recurrence and late recurrence.