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Erschienen in:
01.11.2012 | Original article
Effects of antiviral therapy on long-term outcome after liver resection for hepatitis B virus-related hepatocellular carcinoma
Erschienen in: Journal of Hepato-Biliary-Pancreatic Sciences | Ausgabe 6/2012
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Background/purpose
We investigated the effects of nucleos(t)ide analogues (NAs) on long-term outcome in patients following curative treatment for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).
Methods
This study involved 70 of the 76 patients who had undergone liver resection for HBV-related HCC in our department; 6 patients were excluded due to non-curative resection or advanced cancer. The 70 patients were divided into three groups, as follows: 13 patients with high serum concentration of HBV DNA (≥4 log10 copies/mL) and no antiviral therapy (high viral group); 46 patients who received antiviral therapy during the serial follow up (antiviral therapy group) because of high viral concentration (≥4 log10 copies/mL); and 11 patients with low serum concentration of HBV DNA (<4 log10 copies/mL) and no antiviral therapy (low viral group).
Results
Tumor-free survival rate was significantly higher in the low viral group than in the high viral group (P = 0.0058). Multivariate analysis revealed that a high serum concentration of HBV DNA (≥4 log10 copies/mL) (risk ratio 6.717, 95% confidence interval 1.435–31.434, P = 0.0156) was an independent risk factor for a short tumor-free survival time. Tumor-free survival rate was significantly higher in the antiviral therapy group than in the high viral group (P = 0.0478). Multivariate analysis revealed that presence of multiple tumors (risk ratio 2.857, 95% confidence interval 1.403–5.816, P = 0.0038) was an independent risk factor for a short tumor-free survival time. The cumulative survival rate was significantly higher in the antiviral therapy group than in the high viral group (P = 0.0025). Multivariate analysis revealed that not undergoing antiviral therapy (risk ratio 0.121, 95% confidence interval 0.024–0.608, P = 0.0104) was an independent risk factor for a short survival time.
Conclusions
A high serum concentration of HBV DNA (≥4 log10 copies/mL) was a strong risk factor for HCC recurrence after resection of HBV-related HCC. Antiviral therapy with NAs improved the long-term outcome after resection of HBV-related HCC in patients with high serum concentrations of HBV DNA.