Open AccessImpact of oral anti–hepatitis B therapy on the survival of patients with hepatocellular carcinoma initially treated with chemoembolization
Author(s) -
Zhou ZhongGuo,
Zheng XingRong,
Zhou Qian,
Shi Ming,
Zhang YaoJun,
Guo RongPing,
Yuan YunFei,
Chen MinShan,
Lin XiaoJun,
Lao XiangMing,
Li ShengPing
Publication year - 2015
Publication title -
cancer communications
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.119
H-Index - 53
ISSN - 2523-3548
DOI - 10.1186/s40880-015-0017-7
Subject(s) - hepatocellular carcinoma , medicine , antiviral therapy , gastroenterology , proportional hazards model , stage (stratigraphy) , hepatitis b virus , survival analysis , hepatitis b , oncology , subgroup analysis , multivariate analysis , antiviral treatment , hepatitis c virus , confidence interval , chronic hepatitis , immunology , virus , paleontology , biology
Most hepatocellular carcinomas (HCC) develop in a background of underlying liver disease including chronic hepatitis B. However, the effect of antiviral therapy on the long‐term outcome of patients with hepatitis B virus (HBV)‐related HCC treated with chemoembolization is unclear. This study aimed to evaluate the survival benefits of anti‐HBV therapy after chemoembolization for patients with HBV‐related HCC. Methods A total of 224 HCC patients who successfully underwent chemoembolization were identified, and their survival and other relevant clinical data were reviewed. Kaplan‐Meier and Cox regression analyses were performed to validate possible effects of antiviral treatment on overall survival (OS). Results The median survival time (MST) was 15.9 (95% confidence interval [CI], 9.5–27.7) months in the antiviral group and 9.6 (95% CI, 7.8–13.7) months in the non‐antiviral group (log‐rank test, P = 0.044). Cox multivariate analysis revealed that antiviral treatment was a prognostic factor for OS ( P = 0.008). Additionally, a further analysis was based on the stratification of the TNM tumor stages. In the subgroup of early stages, MST was significantly longer in the antiviral‐treatment group than in the non‐antiviral group (61.8 months [95% CI, 34.8 months to beyond the follow‐up period] versus 26.2 [95% CI, 14.5–37.7] months, P = 0.012). Multivariate analysis identified antiviral treatment as a prognostic factor for OS in the early‐stage subgroup ( P = 0.006). However, in the subgroup of advanced stages, MST of the antiviral‐treated group was comparable to that of the non‐antiviral group (8.4 [95% CI, 5.2–13.5] months versus 7.4 [95% CI, 5.9–9.3] months, P = 0.219). Multivariate analysis did not indicate that antiviral treatment was a significant prognostic factor in this subgroup. Conclusion Antiviral treatment is associated with prolonged OS time after chemoembolization for HCC, especially in patients with early‐stage tumors.