Zhen-Li Li1, Wen-Tao Yan1,2, Jin Zhang1, Yi-Jun Zhao1, Wan Yee Lau1,3, Xian-Hai Mao4, Yong-Yi Zeng5, Ya-Hao Zhou6, Wei-Min Gu7, Hong Wang8, Ting-Hao Chen9, Jun Han1, Hao Xing1, Han Wu1, Chao Li1, Ming-Da Wang1, Meng-Chao Wu1, Feng Shen10, Tian Yang11. 1. Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, No. 225, Changhai Road, Shanghai, 200438, China. 2. Department of Clinical Medicine, Second Military Medical University, Shanghai, China. 3. Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong SAR. 4. Department of Hepatobiliary Surgery, The People's Hospital of Hunan Province, Changsha, Hunan, China. 5. Department of Hepatobiliary Surgery, Mengchao Hepatobiliary Hospital, Fujian Medical University, Fuzhou, Fujian, China. 6. Department of Hepatobiliary Surgery, Pu'er People's Hospital, Pu'er, Yunnan, China. 7. The First Department of General Surgery, The Fourth Hospital of Harbin, Harbin, Heilongjiang, China. 8. Department of General Surgery, Liuyang People's Hospital, Liuyang, Hunan, China. 9. Department of General Surgery, Ziyang First People's Hospital, Ziyang, Sichuan, China. 10. Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, No. 225, Changhai Road, Shanghai, 200438, China. fengshensmmu@gmail.com. 11. Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, No. 225, Changhai Road, Shanghai, 200438, China. yangtianehbh@smmu.edu.cn.
Abstract
BACKGROUND: Hepatitis B virus (HBV) infection is the leading cause of hepatocellular carcinoma (HCC) worldwide. The aim of the study was to identify the incidence and predictive factors of actual 10-year survival following liver resection of HBV-related HCC. METHODS: A Chinese multicenter database of patients undergoing curative hepatectomy of HBV-related HCC was reviewed. Patients who survived ≥ 10 years and patients who died < 10 years after surgery were compared and analyzed. Univariable and multivariable regression analyses were performed to identify predictive factors associated with 10-year survival. RESULTS: Among all enrolled 1016 patients, the actuarial 10-year survival rate was 24.1%, while the actual 10-year survival rate was 16.6%. There were 169 patients who survived at least 10 years after surgery and 688 who died within 10 years from surgery. These patients constituted the study population of this study. Multivariable regression analysis revealed that cirrhosis, preoperative HBV viral load > 104 copies/mL, maximum tumor size > 5 cm, multiple tumors, macroscopic and microscopic vascular invasion, postoperative HBV reactivation, and early recurrence (< 2 years after surgery) were independent risk factors associated with actual 10-year survival, while postoperative antiviral therapy, regular recurrence surveillance, and curative treatments for initial recurrence were independent protective factors. CONCLUSIONS: The actual 10-year survival after curative resection of HBV-related HCC was calculated to be 16.6%. Postoperative antiviral therapy and regular recurrence surveillance were independent protective factors associated with actual 10-year survival after liver resection of HBV-related HCC.
BACKGROUND:Hepatitis B virus (HBV) infection is the leading cause of hepatocellular carcinoma (HCC) worldwide. The aim of the study was to identify the incidence and predictive factors of actual 10-year survival following liver resection of HBV-related HCC. METHODS: A Chinese multicenter database of patients undergoing curative hepatectomy of HBV-related HCC was reviewed. Patients who survived ≥ 10 years and patients who died < 10 years after surgery were compared and analyzed. Univariable and multivariable regression analyses were performed to identify predictive factors associated with 10-year survival. RESULTS: Among all enrolled 1016 patients, the actuarial 10-year survival rate was 24.1%, while the actual 10-year survival rate was 16.6%. There were 169 patients who survived at least 10 years after surgery and 688 who died within 10 years from surgery. These patients constituted the study population of this study. Multivariable regression analysis revealed that cirrhosis, preoperative HBV viral load > 104 copies/mL, maximum tumor size > 5 cm, multiple tumors, macroscopic and microscopic vascular invasion, postoperative HBV reactivation, and early recurrence (< 2 years after surgery) were independent risk factors associated with actual 10-year survival, while postoperative antiviral therapy, regular recurrence surveillance, and curative treatments for initial recurrence were independent protective factors. CONCLUSIONS: The actual 10-year survival after curative resection of HBV-related HCC was calculated to be 16.6%. Postoperative antiviral therapy and regular recurrence surveillance were independent protective factors associated with actual 10-year survival after liver resection of HBV-related HCC.
Entities:
Keywords:
Hepatectomy; Hepatitis B virus; Hepatocellular carcinoma; Overall survival
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