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Erschienen in:
01.03.2015 | Hepatobiliary Tumors
High Levels of Hepatitis B Surface Antigen are Associated with Poorer Survival and Early Recurrence of Hepatocellular Carcinoma in Patients with Low Hepatitis B Viral Loads
Erschienen in: Annals of Surgical Oncology | Ausgabe 3/2015
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Purpose
Recurrence is a disastrous outcome in patients with hepatitis-related hepatocellular carcinoma (HCC) who have undergone curative resection, and little is known about whether high levels of hepatitis B surface antigen (HBsAg) increase the risk of HCC recurrence.
Patients and Methods
This retrospective study included 1,360 HBsAg-positive postoperative HCC patients with hepatitis B viral (HBV) DNA levels < 2000 IU/mL, including 298 patients in a training cohort and 1,062 patients in a validation cohort. The prognostic value of the HBsAg level was evaluated using Cox regression and Kaplan–Meier analyses.
Results
We demonstrated that 1,000 IU/mL, but not 10 or 100 IU/mL, was a meaningful cutoff level for significantly discriminating these patients into an HBsAgLow group and an HBsAgHigh group based on correlations between the HBsAg level and liver cirrhosis (p = 0.028), tumor size (p = 0.039), and hepatitis B e antigen level (p < 0.001). The postoperative 1-, 3-, and 5-year overall survival (OS) rates of HCC patients in the HBsAgLow group were significantly higher than those of HCC patients in the HBsAgHigh group. Accordingly, the 5-year recurrence-free survival (RFS) rates of patients in the HBsAgLow group were markedly higher than those of HCC patients in the HBsAgHigh group. The HBsAg level was a prognostic indicator for OS (p = 0.014) and RFS (p = 0.01).
Conclusion
HBsAg level is correlated with more aggressive tumor behavior and serves as a prognostic indicator in patients with surgically resected HCC with low HBV load.