Antiviral Therapy Reduces Hepatocellular Carcinoma Recurrence in Patients With Low HBV-DNA Levels
| Autor: | Zeya Pan, Weiping Zhou, Mengchao Wang, Ling-Hao Zhao, Wan Y. Lau, Gang Huang, Peng-Peng Li, Zhen-Guang Wang |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Oncology Hepatitis B virus medicine.medical_specialty Carcinoma Hepatocellular medicine.disease_cause Antiviral Agents law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine medicine Carcinoma Humans In patient Prospective Studies Prospective cohort study Survival rate Telbivudine business.industry Liver Neoplasms Antiviral therapy Middle Aged medicine.disease digestive system diseases Survival Rate 030220 oncology & carcinogenesis Hepatocellular carcinoma DNA Viral Female 030211 gastroenterology & hepatology Surgery Neoplasm Recurrence Local business |
| Zdroj: | Annals of Surgery. 268:943-954 |
| ISSN: | 1528-1140 0003-4932 |
| DOI: | 10.1097/sla.0000000000002727 |
| Popis: | Despite antiviral treatment has been shown to reduce hepatocellular carcinoma (HCC) recurrence after curative treatment for hepatitis B virus (HBV)-related HCC in patients with high preoperative HBV-DNA levels, it is still unclear whether antiviral therapy is useful in reducing recurrence in patients with low preoperative HBV-DNA levels.In this randomized controlled trial, 200 patients who underwent curative resection for HCC with low baseline HBV-DNA levels were randomly assigned to receive preemptive antiviral therapy or not. The primary endpoints were recurrence-free survival. This study was censored on March 31, 2015 when all surviving patients had a minimum follow-up of 60 months. The analysis was done on an intention-to-treat basis.The baseline clinical, laboratory, and tumor characteristics of the 2 groups were comparable. The 1-, 3-, and 5-year recurrence-free survival rates for the antiviral group and the control group were 85.9%, 55.2%, and 52.0% and 80.6%, 40.9%, and 32.3%, respectively. The corresponding overall survival rates for the 2 groups were 94.0%, 75.7%, and 64.1% and 90.0%, 62.4%, and 43.7%, respectively. The recurrence-free survival and overall survival for the antiviral group were significantly better than the control group (P = 0.016, P = 0.004, respectively). After adjusting for confounding prognostic factors in a Cox model, the relative risks of recurrence and death for antiviral treatment were 0.601 [95% confidence interval (CI), 0.409-0.884; P = 0.010] and 0.509 (95% CI, 0.333-0.778; P = 0.002), respectively. Antiviral therapy was an independent protective factor of late tumor recurrence (hazard ratio [HR] = 0.316, 95% CI 0.157-0.637; P = 0.001) but not of early tumor recurrence (HR = 0.782, 95% CI, 0.493-1.240; P = 0.296).In patients with low preoperative HBV-DNA levels, antiviral therapy significantly reduced HCC recurrence after R0 hepatic resection. |
| Databáze: | OpenAIRE |
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