title: Nucleot(s)ide analogues for hepatitis B virus-related hepatocellular carcinoma after curative treatment: a systematic review and meta-analysis.
abstract: OBJECTIVE
  The benefit of nucleot(s)ide analogues (NA) for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after curative treatment has been widely debated due to the relatively weak evidence. The objective of this systematic review was to evaluate the effect of NA on recurrence and survival after curative treatment of HBV-HCC.
  
  
  METHODS
  A systematic electronic search was performed. All controlled trials comparing NA versus placebo or no treatment were considered for inclusion. Results were expressed as Hazard Ratio for recurrence and survival with 95% confidence intervals using RevMan 5.2.
  
  
  RESULTS
  We included 13 trials with 6350 patients. There were significant improvements for recurrence-free survival (HR 0.66, 95% CI 0.54-0.80; p<0.0001) and overall survival (HR 0.56, 95% CI 0.43-0.73; p<0.0001) in the adjuvant NA group compared with the control group. Sensitivity analyses confirmed the robustness of the results. There were no serious adverse effects being reported. Lamivudine resistance was from 28.6% to 37.5% but could be rescued by other types of NA or combination therapy.
  
  
  CONCLUSIONS
  Our study suggested benefits of adjuvant NA therapy following curative treatment of HBV-HCC. Since the great proven efficacy of NA in improving clinical and viral parameters besides HCC, further studies should be focused on broadening the indications for NA therapy after curative treatment of HBV-HCC.
authors: Hepatobiliary Surgery Centre, Union hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors: Ping
authors: P
authors: Sun
authors: Department of Pathology, Union hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors: Xiaochuan
authors: X
authors: Dong
authors: Hepatobiliary Surgery Centre, Union hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors: Xiang
authors: X
authors: Cheng
authors: Hepatobiliary Surgery Centre, Union hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors: Qinggang
authors: Q
authors: Hu
authors: Hepatobiliary Surgery Centre, Union hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors: Qichang
authors: Q
authors: Zheng
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality / Q000601:surgery; D016022:Case-Control Studies; D024882:Drug Resistance, Viral; D005260:Female; D006498:Hepatectomy; D006515:Hepatitis B virus / Q000187:drug effects / Q000502:physiology; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality / Q000601:surgery; D016019:Survival Analysis
chemical_list: D000998:Antiviral Agents; D019259:Lamivudine