title: Association between nucleos(t)ide analog and tumor recurrence in hepatitis B virus-related hepatocellular carcinoma after radiofrequency ablation.
abstract: Radiofrequency ablation (RFA) is the best choice for curative treatment of hepatocellular carcinoma (HCC) cases not suitable for surgical intervention, but efforts should be made to reduce the risk of tumor recurrence. We aimed to investigate the association between nucleos(t)ide analog (NA) therapy for hepatitis B virus (HBV) and the risk of HCC recurrence post-RFA. Using the Taiwan National Health Insurance Research Database between July 1, 2004 and December 31, 2012, we screened 48,807 patients with newly diagnosed HBV-related HCC. We identified 850 patients (200 patients who used NAs for more than 90 days and 650 who never used NA post-RFA) who received RFA as a potentially curative treatment for HCC. Patients in the NA-treated cohort were randomly matched 1:2 with patients in the untreated cohort by age, sex, cirrhosis, and the time period between RFA and initiation of NA therapy. Finally, 133 patients were recruited in the NA-treated group and 266 in the untreated group for analysis. Cumulative incidences of and hazard ratios (HRs) for HCC recurrence were analyzed after adjusting for competing mortality. The HCC recurrence rate of the NA-treated group was significantly lower than that of the untreated group (2-year recurrence rate: 41.8%; 95% confidence interval [CI]: 32.9-50.6 vs. 54.3%; 95% CI: 48.0-60.6; modified log-rank test: P < 0.05). In modified Cox's regression analysis, NA therapy was independently associated with a decreased risk of HCC recurrence (HR, 0.69; 95% CI: 0.50-0.95; P < 0.05). Multivariate stratified analyses verified the association of NA therapy and decreased HCC recurrence in almost all patient subgroups.
  
  
  CONCLUSIONS
  NA therapy was associated with a decreased risk of HCC recurrence among patients with HBV-related HCC post-RFA.
authors.affiliation: Division of Gastroenterology & Hepatology, Taichung Veterans General Hospital, Taichung, Taiwan.|Department of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Teng-Yu
authors.initials: TY
authors.lastname: Lee
authors.affiliation: School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.|Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan.|Center for Health Policy Research and Development, National Health Research Institutes, Miaoli, Taiwan.
authors.forename: Jaw-Town
authors.initials: JT
authors.lastname: Lin
authors.affiliation: Division of Gastroenterology & Hepatology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Yi-Siou
authors.initials: YS
authors.lastname: Zeng
authors.affiliation: Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.|Department of Dermatology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Yi-Ju
authors.initials: YJ
authors.lastname: Chen
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Ming-Shiang
authors.initials: MS
authors.lastname: Wu
authors.affiliation: Division of Gastroenterology & Hepatology, Taichung Veterans General Hospital, Taichung, Taiwan.|Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.|College of Public Health and Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.|Department of Life Sciences, National Chung-Hsing University, Taichung, Taiwan.
authors.forename: Chun-Ying
authors.initials: CY
authors.lastname: Wu
mesh_terms: D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects*; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000601:surgery*; D017115:Catheter Ablation; D015331:Cohort Studies; D005260:Female; D006509:Hepatitis B / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008113:Liver Neoplasms / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009705:Nucleosides / Q000009:adverse effects; D011379:Prognosis; D016016:Proportional Hazards Models
chemical_list: D000998:Antiviral Agents; D009705:Nucleosides