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Effects of antiviral therapy on long‐term outcome after liver resection for hepatitis B virus‐related hepatocellular carcinoma
Author(s) -
Urata Yorihisa,
Kubo Shoji,
Takemura Shigekazu,
Uenishi Takahiro,
Kodai Shintaro,
Shinkawa Hiroji,
Sakae Masayuki,
Kaneda Kazuhisa,
Ohata Kazunori,
Nozawa Akinori,
Suehiro Shigefumi
Publication year - 2012
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1007/s00534-011-0489-z
Subject(s) - hepatocellular carcinoma , medicine , antiviral therapy , hepatitis b virus , gastroenterology , confidence interval , hepatitis b , viral load , hepatitis c virus , liver cancer , multivariate analysis , oncology , virus , virology , chronic hepatitis
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 log 10 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 log 10 copies/mL); and 11 patients with low serum concentration of HBV DNA (<4 log 10 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 log 10 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 log 10 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.