title: Efficacy of antiviral therapy with nucleotide/nucleoside analogs after curative treatment for patients with hepatitis B virus-related hepatocellular carcinoma: A systematic review and meta-analysis.
abstract: OBJECTIVE
  A systematic review was conducted to evaluate whether or not antiviral therapy with nucleotide/nucleoside analogs (NA) have survival benefit for patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after curative treatment.
  
  
  METHODS
  An electronic search of PubMed, EMBASE, and the Cochrane Library was performed to identify comparative studies in which the adjuvant effects of NA for patients with HBV-related HCC after curative treatment were evaluated. Primary outcome included survival rate, and secondary outcomes included tumor recurrence rate and side effects. Review Manager 5.1.6 software was used for meta-analysis.
  
  
  RESULTS
  Twelve studies involving 6682 patients were included in our review. Meta-analysis results demonstrated that significant differences favoring the antiviral treatment groups were observed in 1-year survival rate (RR: 0.65, 95% CI: 0.53-0.79, P<0.0001), 3-year survival rate (RR: 0.58, 95% CI: 0.46-0.74, P<0.0001), and 5-year survival rate (RR: 0.56, 95% CI: 0.43-0.74, P<0.0001) compared with the control group. After NA was administered, recurrence was significantly reduced after one year (RR: 0.77, 95% CI: 0.64-0.93, P=0.006) and three years (RR: 0.81, 95% CI: 0.71-0.93, P=0.002) but not after five years (RR: 0.94, 95% CI: 0.76-1.16, P=0.55) compared with non-NA therapy.
  
  
  CONCLUSIONS
  Current evidence showed that antiviral therapy with NA could improve survival and reduce early recurrence for patients with HBV-related HCC after curative treatment. More high-quality prospective trials are expected.
authors: Department of General Surgery, Lanzhou University Second Hospital, Lanzhou, Gansu, China.
authors: Bo Wei
authors: BW
authors: Xia
authors: Department of General Surgery, Lanzhou University Second Hospital, Lanzhou, Gansu, China.
authors: You Cheng
authors: YC
authors: Zhang
authors: Department of General Surgery, First Hospital of Lanzhou University, Lanzhou, Gansu, China.
authors: Jun
authors: J
authors: Wang
authors: Department of General Surgery, First Hospital of Lanzhou University, Lanzhou, Gansu, China.
authors: Fang Hui
authors: FH
authors: Ding
authors: Department of General Surgery, Lanzhou University Second Hospital, Lanzhou, Gansu, China. Electronic address: hexdedu@163.com.
authors: Xiao Dong
authors: XD
authors: He
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000628:therapy* / Q000821:virology; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000628:therapy* / Q000821:virology; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000401:mortality; D015996:Survival Rate
chemical_list: D000998:Antiviral Agents