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We read with interest the updated meta-analysis by Yuan et al. [1] which investigated the role of nucleos(t)ide analog (NA) therapy for patients with hepatitis B virus (HBV) related hepatocellular carcinoma (HCC) after surgery. Even after curative resection or ablation, the incidence of HCC recurrence is very high [2]. However, no adjuvant and/or postoperative therapies with definite efficacy to prevent HCC recurrence are recommended by official guidelines. HBV is the main cause of HCC in Asia. In this point, Yuan and coworkers [1] performed an interesting and important updated meta-analysis in order to determine whether antiviral therapy with NA can prevent HCC recurrence and improve patients' survival after surgery. Their meta-analysis showed that NA therapy significantly reduced 1- and 3-year recurrence and significantly improved 1-, 3-, and 5-year overall survival and disease-free survival. We feel that some of these results may need to be treated with caution. And we would like to propose several important issues raised in this meta-analysis.

canadian journal of gastroenterology and hepatology

Comment on “Evaluation of Antiviral Therapy Performed after Curative Therapy in Patients with HBV-Related Hepatocellular Carcinoma: An Updated Meta-Analysis”