title: Antiviral therapy decreases recurrence of hepatitis B virus-related hepatocellular carcinoma after curative resection: a meta-analysis.
abstract: BACKGROUND
  The long-term outcome after curative resection of hepatocellular carcinoma (HCC) remains unsatisfactory because of the high incidence of recurrence. The present study was intended to assess the impact of hepatitis B virus (HBV) DNA level and nucleos(t)ide analog therapy on posthepatectomy recurrence of HBV-related HCC.
  
  
  METHODS
  Eligible studies were identified through a computerized literature search. The pooled relative risk ratio (RR) with 95 % confidence interval (CI) was calculated using Review Manager 5.1 Software.
  
  
  RESULTS
  Twenty studies with a total of 8,204 participants were included for this meta-analysis. Pooled analysis showed that high viral load was significantly associated with risk of recurrence (RR: 1.85, 95 % CI: 1.41-2.42; P < 0.001), poorer disease-free survival (DFS) (RR: 1.96, 95 % CI: 1.62-2.38; P < 0.001), and poorer overall survival (OS) (RR: 1.47, 95 % CI: 1.22-1.77; P < 0.001) of HBV-related HCC after surgical resection. Nucleos(t)ide analog therapy significantly decreased the recurrence risk (RR: 0.69, 95 % CI: 0.59-0.80; P < 0.001) and improved both DFS (RR: 0.70, 95 % CI: 0.58-0.83; P < 0.001) and OS (RR: 0.46, 95 % CI: 0.32-0.68; P < 0.001).
  
  
  CONCLUSIONS
  High DNA level is associated with posthepatectomy recurrence of HBV-related HCC. Nucleos(t)ide analog therapy improves the prognosis of HBV-related HCC after resection.
authors.affiliation: Department of Hepatobiliary & Pancreatovascular Surgery, Oncologic Center of Xiamen, First Affiliated Hospital of Xiamen University, 55 Zhenhai Road, Xiamen, 361003, China, zhouymsxy@sina.cn.
authors.forename: Yanming
authors.initials: Y
authors.lastname: Zhou
authors.forename: Zhansai
authors.initials: Z
authors.lastname: Zhang
authors.forename: Yanfang
authors.initials: Y
authors.lastname: Zhao
authors.forename: Lupeng
authors.initials: L
authors.lastname: Wu
authors.forename: Bin
authors.initials: B
authors.lastname: Li
mesh_terms: D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000601:surgery*; D004279:DNA, Viral / Q000097:blood*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006515:Hepatitis B virus / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control* / Q000821:virology; D012307:Risk Factors; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral