title: A long-term study of the effects of antiviral therapy on survival of patients with HBV-associated hepatocellular carcinoma (HCC) following local tumor ablation.
abstract: The ultimate goal of antiviral therapy for chronic hepatitis B (CHB) is prevention of hepatocellular carcinoma (HCC). Earlier we reported favorable effects of antiviral therapy on survival of HCC patients following curative tumor ablation (Int J Cancer online 14 April 2010; doi: 10.1002/ijc.25382). It was the first observation made in the United States. We now report 12 year follow-up of this patient group. CHB patients with no prior antiviral therapy with a single HCC (≤ 7 cm) were studied. All patients underwent local tumor ablation as their first option. Patients diagnosed before 1999 received no antiviral treatment while those diagnosed after 1999 received antiviral treatment. Survival between the treated and untreated groups was compared. Among 555 HCC patients seen at our clinic between 1991 and 2013, 25 subjects were eligible. Nine subjects (all male patients, median age 53 years [46-66]) did not receive antiviral therapy while 16 (14 male patients, median age 56 years [20-73]) received treatment. Between the two groups, there was no difference in their median tumor size and levels of alpha-fetoprotein and albumin. However, the survival was significantly different (P = 0.001): the median survival of the untreated was 16 months (3-36 months) while that of the treated was 80 months (15-152 months). Fourteen of 16 treated patients are alive to date with two longest survivors alive for ≥ 151 months. In conclusion, concomitant antiviral therapy for CHB patients with HCC reduces and prevents new/recurrent tumor and improves survival. This novel treatment strategy offers an alternative to liver transplantation in patients with HBV-associated HCC.
authors: Liver Disease Prevention Center, Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania; Division of Gastroenterology and Hepatology, Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors: Hie-Won
authors: HW
authors: Hann
authors: Robert
authors: R
authors: Coben
authors: Daniel
authors: D
authors: Brown
authors: Laurence
authors: L
authors: Needleman
authors: Ernest
authors: E
authors: Rosato
authors: Albert
authors: A
authors: Min
authors: Richard S
authors: RS
authors: Hann
authors: Kyong Bin
authors: KB
authors: Park
authors: Stephen
authors: S
authors: Dunn
authors: Anthony J
authors: AJ
authors: DiMarino
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000628:therapy* / Q000821:virology*; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000628:therapy* / Q000821:virology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D000998:Antiviral Agents
keywords: Antiviral therapy and survival; hepatitis B; hepatocellular carcinoma; tumor ablation