Efficacy of antiviral therapy with lamivudine after initial treatment for hepatitis B virus-related hepatocellular carcinoma.
OBJECTIVE
The aim of this study was to determine whether antiviral therapy with lamivudine is beneficial in patients after initial treatment for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).


METHODS
Forty-nine consecutive patients with HBV-related HCC completely treated by hepatic resection or radiofrequency ablation were retrospectively enrolled in this study. Comparison was made between 16 patients who received lamivudine therapy at a dose of 100 mg/day after treatment for HCC (lamivudine group) and 33 patients who did not (control group) in terms of changes in remnant liver function, HCC recurrence and survival.


RESULTS
Cumulative recurrence rates of HCC did not significantly differ between the two groups (P = 0.622). However, median Child-Pugh score at the time of HCC recurrence was significantly different; 5 (range 5-6) in the lamivudine group versus 7 (range 5-12) in the control group (P = 0.005). All patients in the lamivudine group were able to receive curative treatment for recurrent HCC. In contrast, 10 of 15 patients in the control group were unable to receive curative optimal therapy for recurrent HCC due to deterioration of remnant liver function. The cumulative survival rates of patients in the lamivudine group tended to be higher than those of patients in the control group (P = 0.063).


CONCLUSIONS
It is suggested that lamivudine therapy is beneficial for patients after initial treatment for HBV-related HCC because it contributes to improving remnant liver function, thus decreasing the risk of liver failure and increasing the chances of receiving available treatment modalities for recurrent HCC.
Kuzuya
Teiji
T
Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Katano
Yoshiaki
Y
Kumada
Takashi
T
Toyoda
Hidenori
H
Nakano
Isao
I
Hirooka
Yoshiki
Y
Itoh
Akihiro
A
Ishigami
Masatoshi
M
Hayashi
Kazuhiko
K
Honda
Takashi
T
Goto
Hidemi
H
D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery / Q000821:virology; D017115:Catheter Ablation; D004279:DNA, Viral / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D019259:Lamivudine / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery / Q000821:virology; D008297:Male; D008875:Middle Aged; D009154:Mutation; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D000998:Antiviral Agents; D004279:DNA, Viral; D019259:Lamivudine