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Hepatitis B virus mutation may play a role in hepatocellular carcinoma recurrence: A systematic review and meta‐regression analysis
Author(s) -
Zhou Huaying,
Luo Yue,
Chen Wendong,
Gong Guozhong
Publication year - 2015
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12917
Subject(s) - hepatocellular carcinoma , medicine , meta analysis , hepatitis b virus , virology , mutation , hepatitis c virus , carcinoma , hepatitis virus , virus , oncology , genetics , gene , biology
Background and Aims A number of studies have confirmed that antiviral therapy with nucleotide analogs ( NAs ) can improve the prognosis of hepatitis B virus ( HBV )‐related hepatocellular carcinoma ( HCC ) after curative therapy. However, what factors affected the prognosis of HBV ‐ HCC after removal of the primary tumor and inhibition of HBV replication? A meta‐regression analysis was conducted to explore the prognostic factor for this subgroup of patients. Methods MEDLINE , EMBASE , W eb of S cience, and C ochrane library were searched from J anuary 1995 to F ebruary 2014 for clinical trials evaluating the effect of NAs on the prognosis of HBV ‐ HCC after curative therapy. Data were extracted for host, viral, and intervention information. Single‐arm meta‐analysis was performed to assess overall survival ( OS ) rates and HCC recurrence. Meta‐regression analysis was carried out to explore risk factors for 1‐year OS rate and HCC recurrence for HBV ‐ HCC patients after curative therapy and antiviral therapy. Results Fourteen observational studies with 1284 patients met the inclusion criteria. Influential factors for prognosis of HCC were mainly baseline HBeAg positivity, cirrhotic stage, advanced Tumor‐Node‐Metastasis ( TNM ) stage, macrovascular invasion, and antiviral agent type. The 1‐year OS rate decreased by more than four times (coefficient −4.45, P < 0.001) and the 1‐year HCC recurrence increased by more than one time (coefficient 1.20, P = 0.003) when lamivudine was chosen for HCC after curative therapy, relative to entecavir for HCC . Conclusions HBV mutation may play a role in HCC recurrence. Entecavir or tenofovir, a high genetic barrier to resistance, should be recommended for HBV ‐ HCC patients.