Keita Sakamoto1, Toru Beppu2, Hiromitsu Hayashi1, Shigeki Nakagawa1, Hirohisa Okabe1, Hidetoshi Nitta1, Katsunori Imai1, Daisuke Hashimoto1, Akira Chikamoto1, Takatoshi Isiko1, Ken Kikuchi3, Hideo Baba4. 1. Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan. 2. Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan Department of Multidisciplinary Treatment for Gastroenterological Cancer, Kumamoto University, Kumamoto, Japan. 3. Medical Quality Management Center, Graduate School of Social and Cultural Sciences, Kumamoto University, Kumamoto, Japan. 4. Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan hdobaba@kumamoto-u.ac.jp.
Abstract
AIM: The aim of this study was to determine whether antiviral therapy with nucleotide/nucleoside analog (NA) is beneficial for Japanese patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) who underwent initial curative liver resection. PATIENTS AND METHODS: In 162 patients with positive hepatitis B surface antigen and negative anti-hepatitis C virus antibody, sixty-two patients received antiviral therapy with NA (NA group) and the remaining 100 patients did not (non-NA group). Prognostic factors for disease-free survival (DFS) and overall survival (OS) were evaluated. Moreover, to equalize the background covariates, a one-to-one propensity case-matched analysis was used. RESULTS: NA administered were lamivudine (LAM) solely for 21 patients, LAM plus adefovir dipivoxil (ADV) for 6, LAM switched to entecavir (ETV) for 5 and ETV solely for 31. DFS did not significantly differ between the NA group and non-NA group (p=0.19). However, OS was significantly different (p=0.0063); 1-,3- and 5-year OS were 100% and 85.9%, 88.3% and 61.9% and 65.1% and 58.0%, respectively. In multivariate analysis, no antiviral therapy with NA was an independent poor prognostic factor (hazard ratio (HR)=2.72; p=0.0229). However, after propensity case-matched analysis, disease-free and overall survival were not significantly different between the two groups. CONCLUSION: In a Japanese cohort, antiviral therapy with NAs might provide longer survival for postoperative HBV-related HCC patients compared to patients without antiviral therapy. However, deterministic evaluation was impossible by this study alone. Copyright
AIM: The aim of this study was to determine whether antiviral therapy with nucleotide/nucleoside analog (NA) is beneficial for Japanese patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) who underwent initial curative liver resection. PATIENTS AND METHODS: In 162 patients with positive hepatitis B surface antigen and negative anti-hepatitis C virus antibody, sixty-two patients received antiviral therapy with NA (NA group) and the remaining 100 patients did not (non-NA group). Prognostic factors for disease-free survival (DFS) and overall survival (OS) were evaluated. Moreover, to equalize the background covariates, a one-to-one propensity case-matched analysis was used. RESULTS: NA administered were lamivudine (LAM) solely for 21 patients, LAM plus adefovir dipivoxil (ADV) for 6, LAM switched to entecavir (ETV) for 5 and ETV solely for 31. DFS did not significantly differ between the NA group and non-NA group (p=0.19). However, OS was significantly different (p=0.0063); 1-,3- and 5-year OS were 100% and 85.9%, 88.3% and 61.9% and 65.1% and 58.0%, respectively. In multivariate analysis, no antiviral therapy with NA was an independent poor prognostic factor (hazard ratio (HR)=2.72; p=0.0229). However, after propensity case-matched analysis, disease-free and overall survival were not significantly different between the two groups. CONCLUSION: In a Japanese cohort, antiviral therapy with NAs might provide longer survival for postoperative HBV-related HCC patients compared to patients without antiviral therapy. However, deterministic evaluation was impossible by this study alone. Copyright
Authors: Monika Pazgan-Simon; Krzysztof A Simon; Ewa Jarowicz; Katarzyna Rotter; Anna Szymanek-Pasternak; Jolanta Zuwała-Jagiełło Journal: Clin Exp Hepatol Date: 2018-09-10