title: Impact of oral anti-hepatitis B therapy on the survival of patients with hepatocellular carcinoma initially treated with chemoembolization.
abstract: BACKGROUND
  Most hepatocellular carcinomas (HCC) develop in a background of underlying liver disease including chronic hepatitis B. However, the effect of antiviral therapy on the long-term outcome of patients with hepatitis B virus (HBV)-related HCC treated with chemoembolization is unclear. This study aimed to evaluate the survival benefits of anti-HBV therapy after chemoembolization for patients with HBV-related HCC.
  
  
  METHODS
  A total of 224 HCC patients who successfully underwent chemoembolization were identified, and their survival and other relevant clinical data were reviewed. Kaplan-Meier and Cox regression analyses were performed to validate possible effects of antiviral treatment on overall survival (OS).
  
  
  RESULTS
  The median survival time (MST) was 15.9 (95% confidence interval [CI], 9.5-27.7) months in the antiviral group and 9.6 (95% CI, 7.8-13.7) months in the non-antiviral group (log-rank test, P = 0.044). Cox multivariate analysis revealed that antiviral treatment was a prognostic factor for OS (P = 0.008). Additionally, a further analysis was based on the stratification of the TNM tumor stages. In the subgroup of early stages, MST was significantly longer in the antiviral-treatment group than in the non-antiviral group (61.8 months [95% CI, 34.8 months to beyond the follow-up period] versus 26.2 [95% CI, 14.5-37.7] months, P = 0.012). Multivariate analysis identified antiviral treatment as a prognostic factor for OS in the early-stage subgroup (P = 0.006). However, in the subgroup of advanced stages, MST of the antiviral-treated group was comparable to that of the non-antiviral group (8.4 [95% CI, 5.2-13.5] months versus 7.4 [95% CI, 5.9-9.3] months, P = 0.219). Multivariate analysis did not indicate that antiviral treatment was a significant prognostic factor in this subgroup.
  
  
  CONCLUSIONS
  Antiviral treatment is associated with prolonged OS time after chemoembolization for HCC, especially in patients with early-stage tumors.
authors.affiliation: Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, Peoples Republic of China. zhouzhg@sysucc.org.cn.
authors.forename: Zhong-Guo
authors.initials: ZG
authors.lastname: Zhou
authors.affiliation: Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, 510630, Peoples Republic of China. sumssums@126.com.
authors.forename: Xing-Rong
authors.initials: XR
authors.lastname: Zheng
authors.affiliation: Epidemiology Research Unit, Translational Medicine Research Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, 510080, Peoples Republic of China. zhouq49@mail.sysu.edu.cn.
authors.forename: Qian
authors.initials: Q
authors.lastname: Zhou
authors.affiliation: Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, Peoples Republic of China. shiming@sysucc.org.cn.
authors.forename: Ming
authors.initials: M
authors.lastname: Shi
authors.affiliation: Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, Peoples Republic of China. zhangyuj@sysucc.org.cn.
authors.forename: Yao-Jun
authors.initials: YJ
authors.lastname: Zhang
authors.affiliation: Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, Peoples Republic of China. guorp@sysucc.org.cn.
authors.forename: Rong-Ping
authors.initials: RP
authors.lastname: Guo
authors.affiliation: Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, Peoples Republic of China. yuanyf@sysucc.org.cn.
authors.forename: Yun-Fei
authors.initials: YF
authors.lastname: Yuan
authors.affiliation: Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, Peoples Republic of China. chenmsh@sysucc.org.cn.
authors.forename: Min-Shan
authors.initials: MS
authors.lastname: Chen
authors.affiliation: Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, Peoples Republic of China. linxj@sysucc.org.cn.
authors.forename: Xiao-Jun
authors.initials: XJ
authors.lastname: Lin
authors.affiliation: Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, Peoples Republic of China. laoxming@mail.sysu.edu.cn.
authors.forename: Xiang-Ming
authors.initials: XM
authors.lastname: Lao
authors.affiliation: Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, Peoples Republic of China. lishp@sysucc.org.cn.
authors.forename: Sheng-Ping
authors.initials: SP
authors.lastname: Li
mesh_terms: D000998:Antiviral Agents; D006528:Carcinoma, Hepatocellular; D016461:Chemoembolization, Therapeutic; D004359:Drug Therapy, Combination; D006515:Hepatitis B virus; D019694:Hepatitis B, Chronic; D006801:Humans; D008113:Liver Neoplasms; D009026:Mortality; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D000998:Antiviral Agents