Antiviral therapy improves survival in patients with HBV infection and intrahepatic cholangiocarcinoma undergoing liver resection
| Autor: | Hongyang Wang, Wen-Ming Cong, Jingfeng Liu, Xuying Wan, Zhenlin Yan, Kui Wang, Zhengqing Lei, Tian Yang, Jun Li, Timothy M. Pawlik, Dong Wu, Yong Xia, Weiping Zhou, Anfeng Si, Meng-Chao Wu, Feng Shen, Wan Y. Lau |
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| Rok vydání: | 2018 |
| Předmět: |
Hepatitis B virus
medicine.medical_specialty Viral reactivation Hepatology Proportional hazards model business.industry Antiviral therapy medicine.disease_cause Gastroenterology Resection Surgery 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Internal medicine medicine 030211 gastroenterology & hepatology In patient business Survival rate Intrahepatic Cholangiocarcinoma |
| Zdroj: | Journal of Hepatology. 68:655-662 |
| ISSN: | 0168-8278 |
| DOI: | 10.1016/j.jhep.2017.11.015 |
| Popis: | Background & Aims The impact of hepatitis B virus (HBV) infection on outcomes after resection of intrahepatic cholangiocarcinoma (ICC) has not been reported. The aim of this study was to examine the impact of antiviral therapy on survival outcomes after liver resection for patients with ICC and underlying HBV infection. Methods Data on 928 patients with ICC and HBV infection who underwent liver resection at two medical centers between 2006 and 2011 were analyzed. Data on viral reactivation, tumor recurrence, cancer-specific survival (CSS) and overall survival (OS) were obtained. Survival rates were analyzed using the time-dependent Cox regression model adjusted for potential covariates. Results Postoperative viral reactivation occurred in 3.3%, 8.3% and 15.7% of patients who received preoperative antiviral therapy, who did not receive preoperative antiviral therapy with a low, or a high HBV-DNA level ( p p p = 0.057, 0.051 and 0.060, respectively). Compared to patients with a high viral level who received no antiviral therapy, patients who initiated antiviral therapy either before or after surgery had better long-term outcomes (HR 0.44 and 0.54 for recurrence; 0.38 and 0.57 for CSS; 0.46 and 0.54 for OS, respectively). Conclusions Viral reactivation was associated with worse prognoses after liver resection for HBV-infected patients with ICC. Antiviral therapy decreased viral reactivation and prolonged long-term survival for patients with ICC and a high viral level. Lay summary Postoperative hepatitis B virus reactivation was associated with an increased complication rate and a decreased survival rate after liver resection in patients with ICC and hepatitis B virus infection. Antiviral therapy before liver resection reduced the risk of postoperative viral reactivation. Both pre- and postoperative antiviral therapy was effective in prolonging patient survival. |
| Databáze: | OpenAIRE |
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