Antiviral therapy and long-term outcome for hepatitis B virus-related hepatocellular carcinoma after curative liver resection in a Japanese cohort.
OBJECTIVE
The aim of this study was to determine whether antiviral therapy with nucleotide/nucleoside analog (NA) is beneficial for Japanese patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) who underwent initial curative liver resection.


METHODS
In 162 patients with positive hepatitis B surface antigen and negative anti-hepatitis C virus antibody, sixty-two patients received antiviral therapy with NA (NA group) and the remaining 100 patients did not (non-NA group). Prognostic factors for disease-free survival (DFS) and overall survival (OS) were evaluated. Moreover, to equalize the background covariates, a one-to-one propensity case-matched analysis was used.


RESULTS
NA administered were lamivudine (LAM) solely for 21 patients, LAM plus adefovir dipivoxil (ADV) for 6, LAM switched to entecavir (ETV) for 5 and ETV solely for 31. DFS did not significantly differ between the NA group and non-NA group (p=0.19). However, OS was significantly different (p=0.0063); 1-,3- and 5-year OS were 100% and 85.9%, 88.3% and 61.9% and 65.1% and 58.0%, respectively. In multivariate analysis, no antiviral therapy with NA was an independent poor prognostic factor (hazard ratio (HR)=2.72; p=0.0229). However, after propensity case-matched analysis, disease-free and overall survival were not significantly different between the two groups.


CONCLUSIONS
In a Japanese cohort, antiviral therapy with NAs might provide longer survival for postoperative HBV-related HCC patients compared to patients without antiviral therapy. However, deterministic evaluation was impossible by this study alone.
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Keita
K
Sakamoto
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan Department of Multidisciplinary Treatment for Gastroenterological Cancer, Kumamoto University, Kumamoto, Japan.
Toru
T
Beppu
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Hiromitsu
H
Hayashi
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Shigeki
S
Nakagawa
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Hirohisa
H
Okabe
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Hidetoshi
H
Nitta
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Katsunori
K
Imai
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Daisuke
D
Hashimoto
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Akira
A
Chikamoto
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Takatoshi
T
Isiko
Medical Quality Management Center, Graduate School of Social and Cultural Sciences, Kumamoto University, Kumamoto, Japan.
Ken
K
Kikuchi
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan hdobaba@kumamoto-u.ac.jp.
Hideo
H
Baba
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery* / Q000821:virology; D015331:Cohort Studies; D004279:DNA, Viral / Q000097:blood; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006509:Hepatitis B / Q000150:complications*; D006515:Hepatitis B virus / Q000235:genetics; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery* / Q000821:virology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies
D000998:Antiviral Agents; D004279:DNA, Viral
Hepatitis B virus; antiviral therapy; hepatocellular carcinoma; nucleotide/nucleoside analog; propensity score-matching