title: A high baseline HBV load and antiviral therapy affect the survival of patients with advanced HBV-related HCC treated with sorafenib.
abstract: OBJECTIVE
  Although a high viral load is an independent risk factor for recurrence of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after surgery, the prognostic impact of viral load on advanced HCC is unclear. This study investigated the impact of baseline HBV load and antiviral therapy on survival of patients with advanced HCC treated with sorafenib.
  
  
  METHODS
  Of 130 patients with advanced HBV-related HCC received first-line sorafenib therapy were evaluated in a multicenter, retrospective study.
  
  
  RESULTS
  No patients experienced severe hepatic impairment because of HBV reactivation during sorafenib therapy. The median progression-free survival (PFS) and overall survival (OS) of all patients were 5.7 and 9.6 months respectively. Patients with a baseline HBV DNA ≤10(4) copies/ml had significantly better OS than those with >10(4) copies/ml (10.4 vs 6.6 months; P = 0.002), but PFS showed an increasing trend (5.8 vs 4.8 months; P = 0.068). Patients who received antiviral therapy had a better trend in OS than those who did not (12.0 vs 8.3 months; P = 0.058), but there was no difference in PFS (6.4 vs 4.1 months; P = 0.280). In a multivariate analysis, the baseline HBV DNA level >10(4) copies/ml (P = 0.001; hazard ration [HR] = 2.294; 95% CI 1.429-3.676) and antiviral therapy (P = 0.038; HR 0.617; 95% CI 0.390-0.975) were independent predictors of OS.
  
  
  CONCLUSIONS
  In patients with advanced HBV-related HCC treated with sorafenib, a high baseline HBV load was an adverse prognostic factor for survival. However, survival was significantly improved with the use of antiviral therapy.
authors: The Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
authors: Yu
authors: Y
authors: Yang
authors: The Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
authors: Feng
authors: F
authors: Wen
authors: The Department of Medical Oncology, Hunan Cancer Hospital/The Affiliated Tumor Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
authors: Jianliang
authors: J
authors: Li
authors: The Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
authors: Pengfei
authors: P
authors: Zhang
authors: The Department of Medical Oncology, Second People's Hospital of Hunan Province, Changsha, China.
authors: Wenhui
authors: W
authors: Yan
authors: The Department of Oncology, Xinqiao Hospital, The Third Military Medical University, Chongqing, China.
authors: Ping
authors: P
authors: Hao
authors: The Department of Hepatobiliary Surgery, Southwest Hospital, Chongqing, China.
authors: Feng
authors: F
authors: Xia
authors: The Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
authors: Feng
authors: F
authors: Bi
authors: The Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
authors: Qiu
authors: Q
authors: Li
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000601:surgery / Q000821:virology*; D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D006498:Hepatectomy; D006515:Hepatitis B virus; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery / Q000821:virology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000821:virology; D009536:Niacinamide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000627:therapeutic use*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D000077157:Sorafenib; D016019:Survival Analysis; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib
keywords: antiviral therapy; hepatitis B; hepatocellular carcinoma; sorafenib; viral load