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Abstract Details
Benefits of entecavir therapy in HBV-related hepatocellular carcinoma patients with compensated cirrhosis after hepatectomy: A ten-year retrospective cohort study.
Liu, Jian (J);Bai, Shilei (S);Shi, Xintong (X);Yuan, Tao (T);Yu, Yongjin (Y);Lin, Jianbo (J);Dai, Chun (C);Wu, Yeye (Y);Cui, Longjiu (L);Zhu, Bin (B);Fu, Xiaohui (X);Wang, Kui (K);Yu, Wenlong (W);Li, Jun (J);
INTRODUCTION: Data on the impact of antiviral therapy(AVT) on the long-term outcomes of hepatitis B virus(HBV)-related hepatocellular carcinoma(HCC) patients with historically-proved cirrhosis after hepatectomy are limited. We aimed to determine the effect of AVT on resected HCC in the background of HBV-related cirrhosis.
MATERIALS AND METHODS: A total of 1396 patients with HBV-related cirrhotic HCC undergoing curative resection were categorized into AVT and no-AVT groups retrospectively. Recurrence rates were compared, especially according to the initiation time of AVT, virological response, and low HBV levels. Early and late recurrence was stratified by 2 years postoperatively.
RESULTS: The 1-, 3-, 5- and 10-year recurrence rates in AVT group(n = 432) were lower than those in no-AVT group(n = 964, 26 %, 49 %, 65 % and 76 % vs. 29 %, 69 %, 87 % and 92 %,p < 0.001). AVT was an independent factor for late, but not early, recurrence(p < 0.001). The late recurrence rates were similar between patients with only postoperative AVT and those with both pre-and postoperative AVT(p = 0.772). In the AVT group, the late recurrence rates in patients with persistent virological response(PVR) were lower than those in patients with low detectable viral levels(LDV, p = 0.003). Logistic regression analysis showed that the time to virological response(p < 0.001) and HBeAg positivity(p < 0.001) were independently associated with LDV. Patients with spontaneous or treatment-induced undetectable HBV showed the lowest and similar late recurrence rates(p = 0.796). Results were similar in multiple sensitivity analyses.
CONCLUSION: Long-term AVT, regardless of preoperative or postoperative initiation, reduced post-resection late recurrence in patients with HCC and cirrhosis, especially in those with PVR.
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