title: Antiviral therapy in the improvement of survival of patients with hepatitis B virus-related hepatocellular carcinoma treated with sorafenib.
abstract: OBJECTIVE
  To evaluate the role of antiviral therapy with nucleoside analogs (NAs) in sorafenib-treated patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).
  
  
  METHODS
  A retrospective cohort study was done in 151 HBV-related HCC patients treated with sorafenib at Sun Yat-sen University Cancer Center between 2007 and 2012. Overall survival (OS), progression-free survival and adverse events were compared in patients treated with/without NAs. Subgroup analysis and Cox regression analysis were performed to determine the efficiency of NAs and prognostic factors for OS.
  
  
  RESULTS
  HBV-related HCC patients (n=151) were identified from our database of HCC patients treated with sorafenib. Patients treated with NAs (antiviral group, n=88) had significantly improved OS compared with the patients who received no NAs (non-antiviral group, n=63; median OS: 16.47 months vs 13.10 months, P=0.03). Patients in the antiviral group had a significant risk reduction of death compared with the non-antiviral group (hazard ratio: 0.67, 95% confidence interval: 0.46-0.98, P=0.04). By subgroup analysis, patients of Barcelona Clinic Liver Cancer (BCLC) stage C and patients with higher presorafenib HBV-DNA level achieved better survival improvement. Antiviral therapy with NAs was one of the independent prognostic factors for OS of HBV-related HCC patients who were treated with sorafenib.
  
  
  CONCLUSIONS
  Antiviral therapy with NAs improved OS of HBV-related HCC patients treated with sorafenib, especially in patients with BCLC stage C disease and higher HBV-DNA level.
authors: Department of Hepatobiliary Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China; State Key Laboratory of Oncology in South China, Guangzhou, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
authors: Li
authors: L
authors: Xu
authors: Hengjun
authors: H
authors: Gao
authors: Junting
authors: J
authors: Huang
authors: Haoyuan
authors: H
authors: Wang
authors: Zhongguo
authors: Z
authors: Zhou
authors: Yaojun
authors: Y
authors: Zhang
authors: Shaohua
authors: S
authors: Li
authors: Minshan
authors: M
authors: Chen
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage*; D000998:Antiviral Agents / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000209:etiology* / Q000401:mortality; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D006509:Hepatitis B / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000209:etiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000008:administration & dosage / Q000031:analogs & derivatives*; D009705:Nucleosides / Q000008:administration & dosage*; D010671:Phenylurea Compounds / Q000008:administration & dosage*; D011379:Prognosis; D012189:Retrospective Studies; D040242:Risk Reduction Behavior; D000077157:Sorafenib; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents; D000998:Antiviral Agents; D009705:Nucleosides; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib
keywords: antiviral therapy; hepatocellular carcinoma; sorafenib; survival