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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.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28746212
OWN - NLM
STAT- MEDLINE
DA  - 20170726
DCOM- 20170807
LR  - 20170807
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 30
DP  - 2017 Jul
TI  - Intermediate-stage hepatocellular carcinoma patients with a high HBV-DNA load may
      benefit from postoperative anti-hepatitis B virus therapy.
PG  - e7608
LID - 10.1097/MD.0000000000007608 [doi]
AB  - 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 &lt; .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.
FAU - Rui, Shaozhen
AU  - Rui S
AD  - General Surgery Department 2, The First Hospital of Lanzhou University, Lanzhou, 
      China.
FAU - Yan, Jun
AU  - Yan J
FAU - Zhang, Hui
AU  - Zhang H
FAU - Wang, Zhengfeng
AU  - Wang Z
FAU - Zhou, Wence
AU  - Zhou W
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Antiviral Agents)
RN  - 0 (Biomarkers, Tumor)
RN  - 0 (DNA, Viral)
SB  - AIM
SB  - IM
MH  - Antiviral Agents/*administration &amp; dosage
MH  - Biomarkers, Tumor/blood
MH  - Carcinoma, Hepatocellular/*drug therapy/pathology/*surgery/virology
MH  - DNA, Viral/blood
MH  - Disease-Free Survival
MH  - Female
MH  - Follow-Up Studies
MH  - Hepatectomy
MH  - Hepatitis B/blood/complications/*drug therapy/virology
MH  - Hepatitis B virus/genetics/physiology
MH  - Humans
MH  - Liver/diagnostic imaging/pathology
MH  - Liver Neoplasms/*drug therapy/pathology/*surgery/virology
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Neoplasm Recurrence, Local
MH  - Neoplasm Staging
MH  - Postoperative Care
MH  - Proportional Hazards Models
MH  - Treatment Outcome
MH  - Viral Load
EDAT- 2017/07/27 06:00
MHDA- 2017/08/08 06:00
CRDT- 2017/07/27 06:00
AID - 10.1097/MD.0000000000007608 [doi]
AID - 00005792-201707280-00043 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Jul;96(30):e7608. doi: 10.1097/MD.0000000000007608.