Comparison of nucleoside and nucleotide analogs in the recurrence of hepatitis B virus‐related hepatocellular carcinoma after surgical resection: A multicenter study

Qi, Wei; Shen, Jian; Dai, Jindong; Wu, Youwei; Leng, Shusheng; Gao, Fengwei; Ran, Shun; Peng, Wei; Zhang, Xiaoyun; Wen, Tianfu; Li, Chuan

doi:10.1002/cam4.4348

Cited by 16 publications

(13 citation statements)

References 37 publications

(81 reference statements)

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“…TDF was associated with a lower risk of recurrence compared to ETV [unadjusted HR (uHR) 0.88, 95% CI 0.80–0.97; I 2 = 44.9%] with a low heterogeneity among the studies (Figure S1). On pooling the aHR reported in 7 studies, 18,19,21,22,24–26 TDF was still associated with a lower risk of recurrence (aHR 0.73, 95% CI 0.65–0.81; I 2 = 67.7%), but with a moderate heterogeneity (Figure 2). Concerning the timing of recurrence reported in 5 studies, 19–21,23,25 TDF reduced the risk of late recurrence compared to ETV (aHR 0.58, 95% CI 0.45–0.76; I 2 = 0.0%) but not early recurrence (aHR 0.88, 95% CI 0.76–1.02; I 2 = 34.8%) (Figure 3).…”

Section: Resultsmentioning

confidence: 99%

“…TDF was associated with a lower risk of overall mortality compared to ETV (uHR 0.53, 95% CI 0.43–0.66; I 2 = 77.4%), with significant heterogeneity among the studies (Figure S2). On pooling the aHR from 5 studies, 19,21–23,26 TDF was still associated with a lower risk of mortality (aHR 0.62, 95% CI 0.50–0.77; I 2 = 80.3%), although there was significant heterogeneity (Figure 4).…”

Section: Resultsmentioning

confidence: 99%

“…The search strategy yielded 769 records, of which nine studies [18][19][20][21][22][23][24][25][26] were included in the final analysis. Figure 1 shows the PRISMA flowchart for the study selection and inclusion process.…”

Section: Study Characteristics and Study Quality Assessmentmentioning

confidence: 99%

“…All the included studies were from Asia. All the studies were retrospective, except for the study by Lee et al 21 Patients underwent resection in seven studies [18][19][20]22,[24][25][26] radiofrequency ablation in one study. 23 The study by Lee et al 21 S1 shows the detailed study quality assessment using NOS.…”

Section: Study Characteristics and Study Quality Assessmentmentioning

confidence: 99%

“…23 The study by Lee et al 21 S1 shows the detailed study quality assessment using NOS. Six studies were of high quality, 19,[21][22][23][24][25] while three were of intermediate quality. 18,20,26…”

Section: Study Characteristics and Study Quality Assessmentmentioning

confidence: 99%

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Tenofovir versus entecavir for tertiary prevention of hepatocellular carcinoma in chronic hepatitis B infection after curative therapy: A systematic review and meta‐analysis

Giri

Agrawal²,

Afzalpurkar³

et al. 2022

Journal of Viral Hepatitis

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Chronic hepatitis B virus (HBV) infection is a global public health problem leading to liver failure, cirrhosis and hepatocellular carcinoma. [1][2][3] Chronic HBV infection and its complications contribute to approximately 780,000 deaths annually. 4,5 One of the most common causes of cancer-related deaths worldwide is hepatocellular carcinoma (HCC), with a high incidence in Asia compared to the rest of the world, mainly due to chronic HBV infection. 6,7 The development of these complications and mortality can be reduced by nucleos(t) ide analogues (NAs). Tenofovir disoproxil fumarate [TDF], Tenofovir alafenamide [TAF] and Entecavir (ETV) are the recommended firstline drugs for the management of chronic HBV infection due to their high barrier to resistance along with high antiviral potency. 8,9 The prevention of HCC in chronic HBV patients is essential to managing these patients. A meta-analysis by Cheung et al 10 reported a lower

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Study Characteristics and Study Quality Assessmentmentioning

confidence: 99%

Section: Study Characteristics and Study Quality Assessmentmentioning

confidence: 99%

Section: Study Characteristics and Study Quality Assessmentmentioning

confidence: 99%

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Tenofovir versus entecavir for tertiary prevention of hepatocellular carcinoma in chronic hepatitis B infection after curative therapy: A systematic review and meta‐analysis

Giri

Agrawal²,

Afzalpurkar³

et al. 2022

Journal of Viral Hepatitis

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Tenofovir vs Entecavir Among Patients With HBV-Related HCC After Resection

Li,

Wang,

et al. 2023

JAMA Netw Open

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ImportanceTenofovir disoproxil and entecavir are both commonly used first-line antiviral treatments, but their comparative recurrence and overall survival (OS) benefits remain unclear.ObjectiveTo explore differences of tenofovir disoproxil vs entecavir in recurrence-free survival (RFS) and OS after liver resection with curative intent in patients with hepatocellular cancer (HCC) related to hepatitis B virus (HBV).Design, Setting, and ParticipantsThis retrospective cohort study was conducted at Eastern Hepatobiliary Surgery Hospital, a tertiary referral hospital in Shanghai, China, between January 4, 2015, and April 1, 2023. Participants included patients with HBV-related HCC who underwent liver resection with curative intent from January 2015 to December 2018. Patients who received tenofovir disoproxil were matched with patients who received entecavir in a 1:1 ratio using propensity score matching. Data were analyzed from April 3 to May 31, 2023.ExposuresReceiving tenofovir disoproxil or entecavir as antiviral treatment for HBV.Main Outcomes and MeasuresPrimary end points were RFS and OS rates.ResultsAmong 4451 patients (mean [SD] age, 58.1 [10.0] years; 3764 male [84.6%]; median [range] follow-up, of 51 [3 to 91] months), 989 patients in each of the groups were selected in propensity score matching. Baseline characteristics were comparable. In propensity score–matched groups, OS rates were 92.2% at 1 year, 70.9% at 3 years, and 54.2% at 5 years in the entecavir group, compared with 90.9% at 1 year, 75.2% at 3 years, and 64.0% at 5 years in the tenofovir disoproxil group. RFS rates were 83.9% at 1 year, 50.0% at 3 years, and 43.3% at 5 years in the entecavir group, compared with 85.3% at 1 year, 55.6% at 3 years, and 51.4% at 5 years in the tenofovir disoproxil group. Patients in the tenofovir disoproxil group had better OS (hazard ratio, 0.82; 95% CI, 0.72 to 0.94; P = .004) and RFS rates (hazard ratio, 0.81; 95% CI, 0.72 to 0.92; P = .001) compared with the entecavir group. Restricted mean survival time differences of entecavir vs tenofovir disoproxil groups were −0.05 (95% CI, −0.18 to 0.08) months at 1 year (P = .45), 0.20 (95% CI, −0.62 to 1.03) months at 3 years (P = .63), and 1.82 (95% CI, 0.14 to 3.51) months at 5 years (P = .03).Conclusions and RelevanceThese findings suggest that in patients undergoing curative liver resection for HBV-related HCC, tenofovir disoproxil was associated with better long-term OS and RFS rates compared with entecavir, providing insights for antiviral treatment.

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