Intermediate-stage hepatocellular carcinoma patients with a high HBV-DNA load may benefit from postoperative anti-hepatitis B virus therapy

Abstract

Liver resection may be beneficial in intermediate-stage hepatocellular carcinoma (HCC), though the benefit of postoperative anti-hepatitis B virus (HBV) therapy in these patients remains unclear. In this study, we sought to evaluate the efficacy of postoperative anti-HBV for intermediate-stage HCC patients who underwent radical liver resection.According to inclusion and exclusion criteria, this study enrolled 202 HCC patients who underwent liver resection and had a high HBV-DNA load. The patients were divided into 2 groups on the basis of postoperative anti-HBV therapy: group A included patients undergoing postoperative anti-HBV therapy, whereas group B patients did not receive any postoperative anti-HBV therapy. Factors including baseline demographics, tumor characteristics, overall long-term survival, tumor-free survival, and tumor recurrence rate were compared between the 2 groups. Moreover, univariate and multivariate analyses were used to identify risk factors of HCC recurrence.Baseline demographics and tumor characteristics were comparable between the groups. The 1-, 3-, and 5-year overall survival rates in group A were 91.3%, 80.9%, and 66.1%, respectively, values that were significantly increased compared with group B (91.7%, 60.7%, and 52.4%, respectively, P = .019). Group A patients also exhibited enhanced 1-, 3-, and 5-year tumor-free survival compared with group B patients (87.0%, 67.0%, and 62.6%, respectively, in group A; 82.1%, 50.0%, and 42.9% in group B, P = .002). In addition, the tumor recurrence rate in group B was significantly increased compared with group A (P < .01). Univariate and multivariate analyses indicated lack of postoperative anti-HBV therapy [hazard ratio (HR) = 0.882; 95% confidence interval (CI), 0.712–0.938; P = .042] to be a predictor of tumor recurrence.For intermediate-stage [Barcelona Clinic Liver Cancer (BCLC) stage B] HCC with a high HBV-DNA load, postoperative anti-HBV therapy after curative resection should be routine adjuvant therapy.

The comparison of different antiviral therapies on the prognosis of hepatitis B virus-related hepatocellular carcinoma after curative treatments

“…The 14 selected studies were published between 2000 and 2019 and involved a total of 2481 patients. [ 9 – 11 , 14 , 18 , 21 , 22 , 37 – 43 ] The longest median follow-up duration was more than 120 months and the shortest median follow-up duration was 60 months. Study characteristics are summarized in Table 1 .…”

“…These studies were performed in 3 different countries (5 in Japan, [ 9 , 40 – 43 ] 8 in China mainland, [ 10 , 11 , 14 , 18 , 21 , 22 , 37 , 38 ] and 1 in the Korea [ 39 ] ); all studies were published in full text. The type of study design included 1 case–control studies, [ 40 ] 11 retrospective observational studies, [ 9 – 11 , 14 , 22 , 37 – 39 , 41 – 43 ] and 2 RCTs. [ 18 , 21 ]…”

“…However, some limitations of this network meta-analysis should be discussed. First of all, most of the included studies are observational studies, [ 9 – 11 , 14 , 22 , 39 – 43 , 49 ] So the results must be interpreted with caution. Second, some extent of heterogeneity in direct comparisons existed.…”

“…[ 2 , 7 ] Studies of large cohorts from China Hong Kong, China Taiwan, and Japan have confirmed that concomitant antiviral therapy with curative treatment reduced the recurrence of HCC. [ 8 – 22 ] However, there was no consensus about which kind of oral antiviral treatment was the best option in the prevention of HBV-related HCC recurrence after curative treatment. The aim of this network meta-analysis was to sum up the current evidence about the efficacy of different nucleos(t)ide analogues on the prognosis of HBV-related HCC after curative treatment.…”

TÌM HIỂU GIÁ TRỊ CHẨN ĐOÁN UNG THƯ GAN CỦA CÁC DẤU ẤN PIVKA II, AFP-L3 TRÊN BỆNH NHÂN XƠ GAN VÀ UNG THƯ GAN CÓ HBsAg (+)

“…Theo tác giả Đào Việt Hằng nghiên cứu đánh giá trên 130 bệnh nhân HCC có chỉ định đốt sóng cao tần từ 2011 -2016 độ tuổi mắc bệnh trung bình là 57,5 ± 10,2 (12) . Nghiên cứu quốc tế theo Rui và cs 2017 ở Trung Quốc, tuổi trung bình mắc HCC trên nhóm VGB đã điều trị là 51,3 ± 12 (13) . Trong nghiên cứu của chúng tôi nam giới chiếm tỷ lệ 89,5%, nữ giới chiếm tỷ lệ 10,5%, tỷ lệ nam/nữ là 8,5/1.…”