title: Prognostic factors in patients with hepatitis B virus-related hepatocellular carcinoma undergoing nucleoside analog antiviral therapy.
abstract: In the present era of entecavir (ETV) use for chronic hepatitis B (CHB), the prognostic factors in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) remain unclear. The aims of the present study were to investigate the prognostic factors in patients with HBV-related HCC treated with ETV who underwent curative therapy. A total of 74 HBV-related HCC patients treated with ETV who underwent curative therapy were analyzed. Predictive factors associated with overall survival (OS) and recurrence-free survival (RFS) were examined using univariate and multivariate analysis. Our study population included 49 males and 25 females with a median age of 62 years. The median observation period was 3.4 years (range, 0.2-11.5 years). The 1-, 3- and 5-year cumulative OS rates were 100, 89.8 and 89.8%, respectively. The corresponding RFS rates were 82.8, 52.1 and 25.6%, respectively. In this study, 73 patients (98.6%) achieved an HBV DNA level of <400 copies/ml during the follow-up period. No viral breakthrough hepatitis, as defined by 1 log increase from nadir, was observed during ETV therapy. According to multivariate analysis, only hepatitis B e antigen (HBeAg) positivity was significantly associated with OS [hazard ratio (HR), 0.058; 95% confidence interval (CI), 0.005-0.645; P=0.020)], whereas HCC stage (HR, 0.359; 95% CI, 0.150-0.859; P=0.021), HBeAg positivity (HR, 0.202; 95% CI, 0.088-0.463; P<0.001) and γ-glutamyl transpeptidase ≥50 IU/l (HR, 0.340; 95% CI, 0.152-0.760; P=0.009) were significant predictive factors linked to RFS. In conclusion, HBeAg positivity was significantly associated with OS and RFS in HBV-related HCC patients treated with ETV who underwent curative therapy. In such patients, close observation is required, even after curative therapy for HCC.
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka 543-0027, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Nishikawa
authors.forename: Norihiro
authors.initials: N
authors.lastname: Nishijima
authors.forename: Akira
authors.initials: A
authors.lastname: Arimoto
authors.forename: Tadashi
authors.initials: T
authors.lastname: Inuzuka
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Kita
authors.forename: Toru
authors.initials: T
authors.lastname: Kimura
authors.forename: Yukio
authors.initials: Y
authors.lastname: Osaki
keywords: entecavir; hepatitis B virus; hepatocellular carcinoma; prognostic factor