Nucleotide Analogs for Patients with HBV-Related Hepatocellular Carcinoma Increase the Survival Rate through Improved Liver Function

Koda, Masahiko; Nagahara, Takakazu; Matono, Tomomitu; Sugihara, Takaaki; Mandai, Mari; Ueki, Minoru; Ohyama, Kenji; Hosho, Keiko; Okano, Jun-ichi; Kishimoto, Yukihiro; Kono, Michimori; Maruyama, Shigeo; Murawaki, Yoshikazu

doi:10.2169/internalmedicine.48.1534

Cited by 44 publications

(76 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…NAs can suppress HBV-DNA replication and promote ALT normalization but cannot affect tumor factors directly, so in theory NAs may prevent late HCC recurrence but have minimal effect on early HCC recurrence. Several retrospective studies and a RCT [27,33,35,39] support this idea. However, the other RCT [38] in our review found that NA therapy significantly decreased early HCC recurrence, while it did not report outcomes on late HCC recurrence.…”

Section: Recurrence-free Survivalmentioning

confidence: 97%

“…These references comprise 17 retrospective studies [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] and 2 RCTs [38,39] . Most of studies come from Asia, including Chinese mainland, Japan, Hong Kong and Tai Wan, which reflects HBV epidemiology and the high incidence of HBV-related HCC in this region.…”

Section: Recurrence-free Survivalmentioning

confidence: 99%

“…Several retrospective studies [21][22][23][26][27][28][29]33,35] showed that NA treatment did not lead to significantly higher recurrence-free survival than non-NA treatment, while other retrospective studies [24,25,[30][31][32]34,36,37] and the RCTs [38,39] showed that NA therapy was associated with significantly higher recurrence-free survival than non-NA treatment.…”

Section: Recurrence-free Survivalmentioning

confidence: 99%

“…Twelve of them, including the RCTs [22,27,[29][30][31][32][33][34][36][37][38][39] , concluded that NA treatment leads to significantly higher overall survival than non-NA treatment, but 3 studies [21,23,26] concluded that NA therapy does not lead to significantly higher overall survival.…”

Section: Postoperative Na Therapy and Overall Survivalmentioning

confidence: 99%

“…First, NA therapy can efficiently suppress HBV replication and reactivation, ease liver inflammation and fibrosis, impede progression of liver disease, and prevent liver failure [21][22][23]27,29,33,38,45] . Second, liver function improvement after NA therapy increases the possibility of curative re-treatment and allows surgeons to remove a larger liver region after recurrence, which means lower risk of residual tumors [23,29,33,45] .…”

Section: Initialmentioning

confidence: 99%

See 4 more Smart Citations

Nucleos(t)ide analogues to treat hepatitis B virus-related hepatocellular carcinoma after radical resection

Yang

Wang

et al. 2014

WJH

View full text Add to dashboard Cite

Significant advances have been made in nucleos(t)ide analogue (NA) therapy to treat chronic hepatitis B, and this therapy reduces the risk of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) in some patients. However, whether NAs can also prevent recurrence after radical resection of HBV-related HCC remains controversial and is an important question, given that most patients will experience recurrence within a few years of curative surgery. Here we systematically reviewed the literature since 2004 on outcomes after administering NAs to patients with HBV-related HCC following radical resection. We focused on treatment indications, duration, effects on recurrence-free survival and overall survival, and the management of NA resistance. We find that patients with HCC should strongly consider NA therapy if they are positive for HBV-DNA, and that the available evidence suggests that postoperative NA therapy can increase both recurrence-free and overall survival. To minimize drug resistance, clinicians should opt for potent analogues with higher resistance barriers, and they should monitor the patient carefully for emergence of NA-resistant HBV.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Antiviral therapy; Hepatitis B virus; Hepatocellular carcinoma; Liver resection; Nucleos(t)ide analogue; Survival rate Core tip: Significant advances have been made in nucleos(t)ide analogue (NA) therapy to treat chronic hepatitis B. However, for patients undergoing radical resection for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC), a number of important questions remain undefined, including when NA therapy should be initiated, how long the treatment should continue, and whether NAs can prevent recurrence after radical resection. Here we review the available evidence on these questions in the Medline database. We focus on NA treatment indications, duration, effects on recurrencefree survival and overall survival, and management of NA resistance in patients with HBV-related HCC.Ke Y, Wang L, Li LQ, Zhong JH. Nucleos(t)ide analogues to treat hepatitis B virus-related hepatocellular carcinoma after radical resection. World J Hepatol 2014; 6(9): 652-659 Available from:

show abstract

Section: Recurrence-free Survivalmentioning

confidence: 97%