title: Impact of antiviral therapy on post-hepatectomy outcome for hepatitis B-related hepatocellular carcinoma.
abstract: The outcome after curative resection for hepatocellular carcinoma (HCC) remains unsatisfactory due to the high recurrence rate after surgery. In patients with hepatitis B virus (HBV)-related HCC, which is the majority of patients with HCC in Asia, a high viral load is a strong risk factor for HCC recurrence. It is logical to believe that antiviral therapy may improve the post-operative outcome by promoting viral clearance and hepatocyte regeneration, as well as improving residual liver volume in HCC patients with hepatitis B. However, the effect of antiviral therapy on clinical outcomes after liver resection in patients with HBV-related HCC remains to be established. There are two main groups of antiviral treatment for HBV-oral nucleos(t)ide analogues and interferon. Interferon treatment reduces the overall incidence of HBV-related HCC in sustained responders. However, side effects may limit its long-term clinical application. Nucleos(t)ide analogues carry fewer side effects and are potent in terms of viral suppression when compared to interferon and are typically implemented for patients with more advanced liver diseases. They may also improve the outcome after curative resection for HBV-related HCC. There are increasing evidence to suggest that antiviral therapy could suppress HBV, decrease the perioperative reactivation of viral replication, reduce liver injury, preserve the liver function before and after operation, and may lower the risk of HCC recurrence. After all, antiviral therapy may improve the survival after liver resection by reducing recurrence and delaying the liver damage by the virus, resulting in a higher chance of receiving aggressive salvage therapy during HCC recurrence.
authors.affiliation: Charing Ching Ning Chong, Paul Bo San Lai, Division of Hepato-biliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Charing Ching Ning
authors.initials: CC
authors.lastname: Chong
authors.affiliation: Charing Ching Ning Chong, Paul Bo San Lai, Division of Hepato-biliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Grace Lai Hung
authors.initials: GL
authors.lastname: Wong
authors.affiliation: Charing Ching Ning Chong, Paul Bo San Lai, Division of Hepato-biliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Paul Bo San
authors.initials: PB
authors.lastname: Lai
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000628:therapy* / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D006498:Hepatectomy; D006515:Hepatitis B virus; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008099:Liver / Q000601:surgery; D008113:Liver Neoplasms / Q000628:therapy* / Q000821:virology; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D016896:Treatment Outcome; D019562:Viral Load; D014775:Virus Activation / Q000187:drug effects; D014779:Virus Replication
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral
keywords: Antiviral therapy; Hepatectomy; Hepatitis B infection; Hepatocellular carcinoma; Liver resection; Outcome