Antiviral therapy in the improvement of survival of patients with hepatitis B virus‐related hepatocellular carcinoma treated with sorafenib

Background and Aim To evaluate the role of antiviral therapy with nucleoside analogs ( NA s) in sorafenib‐treated patients with hepatitis B virus ( HBV )‐related hepatocellular carcinoma ( HCC ). Methods A retrospective cohort study was done in 151 HBV ‐related HCC patients treated with sorafenib at S un Y at‐sen U niversity C ancer C enter between 2007 and 2012. Overall survival ( OS ), progression‐free survival and adverse events were compared in patients treated with/without NA s. Subgroup analysis and C ox regression analysis were performed to determine the efficiency of NA s and prognostic factors for OS . Results HBV ‐related HCC patients ( n  = 151) were identified from our database of HCC patients treated with sorafenib. Patients treated with NA s (antiviral group, n  = 88) had significantly improved OS compared with the patients who received no NA s (non‐antiviral group, n  = 63; median OS : 16.47 months vs 13.10 months, P  = 0.03). Patients in the antiviral group had a significant risk reduction of death compared with the non‐antiviral group (hazard ratio: 0.67, 95% confidence interval: 0.46–0.98, P  = 0.04). By subgroup analysis, patients of B arcelona C linic L iver C ancer ( BCLC ) stage C and patients with higher presorafenib HBV ‐ DNA level achieved better survival improvement. Antiviral therapy with NA s was one of the independent prognostic factors for OS of HBV ‐related HCC patients who were treated with sorafenib. Conclusion Antiviral therapy with NA s improved OS of HBV ‐related HCC patients treated with sorafenib, especially in patients with BCLC stage C disease and higher HBV ‐ DNA level.