Lack of correlation between the antibody to hepatitis B core antigen and survival after surgical resection for hepatitis C virus-related hepatocellular carcinoma

Abstract

Abstract. The impact of antibodies to hepatitis B core antigen (anti-HBc) on survival after curative surgical resection (SR) for hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) remains unclear. The aim of the present study was to examine the relationship between anti-HBc positivity and survival of HCV-related HCC patients who underwent curative SR. A total of 222 patients with HCV-related, hepatitis B surface antigen (HBsAg)-negative HCC who underwent curative SR were analyzed. They included 119 anti-HBcpositive patients (53.6%) and 103 anti-HBc-negative patients (46.4%). Overall survival (OS) and recurrence-free survival (RFS) rates were compared between the two groups. The median follow-up periods in the anti-HBc-positive and antiHBc-negative groups were 3.4 years (range, 0.3-10.9 years) and 3.2 years (range, 0.5-10.9 years), respectively. The 1-, 3-and 5-year cumulative OS rates were 88.8, 70.2 and 50.0%, respectively, in the anti-HBc-positive group and 95.8, 77.1 and 61.7% in the anti-HBc-negative group (P=0.300). The corresponding RFS rates were 68.7, 33.0 and 20.0%, respectively, in the anti-HBc-positive group and 74.4, 38.5 and 16.5% in the anti-HBc-negative group (P=0.482). Multivariate analyses identified serum albumin ≥3.8 g/dl (P=0.005) and the presence of microvascular invasion (P<0.001) as independent factors linked to OS, and interferon therapy after surgery (P=0.011), α-fetoprotein ≥40 ng/ml (P=0.030) and the presence of microvascular invasion (P<0.001) were significant predictors linked to RFS. In subgroup analyses according to maximum tumor size and background liver disease in terms of OS and RFS, no significant difference between the antiHBc-positive and anti-HBc-negative groups was observed except in patients with non-cirrhotic liver in terms of RFS.In conclusion, anti-HBc-positivity is not a useful predictor for survival of patients with HCV-related HCC after curative SR.

The Impact of the Hepatitis B Core Antibody Status on Recurrence in Patients with Non-B Non-C Hepatocellular Carcinoma after Curative Surgery

“…One paper showed the HBcAb-positive as an adverse prognostic factor in NBNC-HCC [13], while the other paper recently has shown the HBcAb-positive as the favorable predictor of recurrence in NBNC-HCC [14], which is consistent with our results. The true impact of HBcAb status on prognosis in NBNC-HCC is therefore still controversial.…”

“…To the best our knowledge, 2 papers have shown the prognosis in patients with HBcAb-positive compared to HBcAb-negative in NBNC-HCC [13,14]. One paper showed the HBcAb-positive as an adverse prognostic factor in NBNC-HCC [13], while the other paper recently has shown the HBcAb-positive as the favorable predictor of recurrence in NBNC-HCC [14], which is consistent with our results.…”

“…This fact suggests that the background and cause of liver carcinogenesis in NBNC-HCC change between the former paper [13] and latter ones [14] including ours. In fact, the rate of HBcAbpositive was different between the former paper (Nishikawa et al [13], 52.3%) and latter ones (Omichi et al [14], 29.0% and the present study, 36.3%, respectively).…”

“…Therefore, there is a possibility that HBcAb positivity constitutes an additional risk for recurrence and poorer survival. However, there have been few papers that showed the prognosis in patients with HBcAb-positive compared to HBcAb-negative in NBNC-HCC [13,14]. The impact of HBcAb positivity on prognosis after curative hepatectomy for NBNC-HCC is still unclear.…”

Clinicopathological characteristics of hepatitis B surface antigen-negative and hepatitis C antibody-negative hepatocellular carcinoma

“…Distance from the resection margin, tumor multiplicity, the presence or absence of diabetes (12,16) and HBV DNA expression (17)(18)(19)(20) are also reported to be factors associated with NBNC HCC prognosis. Thus, the prognostic factors for NBNC HCC identified in the present study are similar to those for virus-related HCC (21,22).…”