A comparative study of antiviral therapy after resection of hepatocellular carcinoma in the immune-active phase of hepatitis B virus infection.
BACKGROUND
The role of antiviral therapy for patients in the immune-active phase of hepatitis B virus (HBV) infection who underwent partial hepatectomy for hepatocellular carcinoma (HCC) is unknown.


METHODS
From January 2004 to June 2007, a nonrandomized comparative study for postoperative antiviral treatment was conducted on patients who underwent curative hepatectomy for advanced HCC. Patients in the treatment group (n = 43) received lamivudine with or without adefovir dipivoxil, while the control group (n = 36) received no antiviral treatment.


RESULTS
The treatment group had a significantly higher HBeAg seroconversion rate (57.2% vs. 5.6%) and a higher HBV DNA suppression rate (87.2% vs. 2.8%) after 12 months of antiviral treatment. The treatment group also had a significantly greater increase in residual liver volume per unit surface area following hepatectomy (78.0 +/- 40.1 cm(3)/m(2) vs. 35.8 +/- 56.0 cm(3)/m(2)) at 6-month postoperation. After a median follow-up of 12 months, there was no significant difference in recurrence rate after surgery between the treatment group and the control group (76.7% and 91.7%). There was a significant difference in the overall survival rate but not in the disease-free survival rate. The 1- and 2-year overall survival rates were 41.9% and 7.0%, respectively, for the treatment group, and 33.3% and 0%, respectively, for the control group. The 1- and 2-year disease-free survival rates were 23.3% and 2.3%, respectively, for the treatment group, and 8.3% and 0%, respectively, for the control group.


CONCLUSIONS
Although nucleoside analogs did not reduce short-term recurrence rate, they promoted postoperative viral clearance and increased residual liver volume, which significantly enhanced tolerance to subsequent therapy for disease recurrence.
Li
Nan
N
Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
Lai
Eric C H
EC
Shi
Jie
J
Guo
Wei-Xing
WX
Xue
Jie
J
Huang
Bing
B
Lau
Wan-Yee
WY
Wu
Meng-Chao
MC
Cheng
Shu-Qun
SQ
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000601:surgery / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006509:Hepatitis B / Q000188:drug therapy* / Q000601:surgery / Q000821:virology; D006514:Hepatitis B Surface Antigens / Q000378:metabolism; D006513:Hepatitis B e Antigens / Q000276:immunology; D006515:Hepatitis B virus / Q000276:immunology*; D006801:Humans; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000601:surgery / Q000821:virology; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
D000998:Antiviral Agents; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens