title: Effects of lamivudine on outcome after liver resection for hepatocellular carcinoma in patients with active replication of hepatitis B virus.
abstract: OBJECTIVE
  Patients with high serum hepatitis B virus (HBV) DNA concentrations are at high risk of tumor recurrence after liver resection for HBV-related hepatocellular carcinoma (HCC).
  
  
  METHODS
  Among 24 patients with high serum HBV DNA concentrations who underwent liver resection for HBV-related HCC, postoperative lamivudine therapy was chosen by 14 (lamivudine group). The other 10 patients were controls.
  
  
  RESULTS
  Clinicopathologic findings did not differ between the groups. Tumor-free survival rate after surgery was significantly higher in the lamivudine than the control group (P = 0.0086). By univariate analysis, multiple tumors were also a risk factor for a short tumor-free survival. By multivariate analysis, lack of lamivudine therapy and multiple tumors were independent risk factors for a short tumor-free survival. In four patients YMDD mutant viruses were detected after beginning lamivudine administration; in two of them, adefovir dipivoxil was administered because of sustained serum alanine aminotransferase elevations.
  
  
  CONCLUSIONS
  Lamivudine therapy improved tumor-free survival rate after curative resection of HBV-related HCC in patients with high serum concentrations of HBV DNA, although careful follow up proved necessary for the detection of YMDD mutant viruses.
authors.affiliation: Departments of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Shoji
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authors.lastname: Kubo
authors.forename: Hiromu
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authors.lastname: Tanaka
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Takemura
authors.forename: Satoshi
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authors.lastname: Yamamoto
authors.forename: Seikan
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authors.lastname: Hai
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Shintaro
authors.initials: S
authors.lastname: Kodai
authors.forename: Hiroji
authors.initials: H
authors.lastname: Shinkawa
authors.forename: Hiroki
authors.initials: H
authors.lastname: Sakaguchi
authors.forename: Akihiro
authors.initials: A
authors.lastname: Tamori
authors.forename: Daiki
authors.initials: D
authors.lastname: Habu
authors.forename: Shuhei
authors.initials: S
authors.lastname: Nishiguchi