title: Randomized clinical trial: Nucleos(t)ide analogues improved survival of CHB-related HCC patients via reducing severity and progression of malignancy.
abstract: BACKGROUND
  The influence of nucleos(t)ide analogues (NAs) to treat Chronic hepatitis B (CHB) related hepatocellular carcinoma (HCC) remains to be explored.
  
  
  OBJECTIVE
  To investigate if NAs reduce the severity and progression of CHB-related HCC.
  
  
  RESULTS
  Among 532 patients, there were 118 or 414 CHB-related HCC with or without NAs therapy, respectively. BCLC scores, serum level of ALT/AST and HBV DNA were compared. During follow-up, the survival period of CHB-related HCC patients with sustained NAs is significantly longer than that with NAs post-HCC and NAs naïve (p < 0.05). Factors significantly associated with the poor overall survival of CHB-related HCC include BCLC scores (hazard ratio, 1.84 [95% confidence interval, 1.57-2.15], p < 0.001), NAs post-HCC or NAs naïve (1.33 [1.07-1.65], p < 0.01), serum AST ≥ 40 IU/L (1.48 [1.03-2.12], p < 0.05) and HBV DNA ≥ 104 copies/ml (1.36 [1.01-1.83], p < 0.001).
  
  
  METHODS
  Outcomes of 532 CHB-related HCC patients with/without NAs were investigated. Overall survival of CHB-related HCC patients, NAs naïve (n = 156), NAs received post-HCC (n = 258) and NAs sustained (n = 118) were determined.
  
  
  CONCLUSIONS
  NAs reduced severity of CHB-related HCC patients. Sustained NAs is an important factor associated with the extended survival of CHB-related HCC patients.
authors.affiliation: Department of Infectious Diseases and Hepatology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Infectious Diseases and Hepatology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Xiaogang
authors.initials: X
authors.lastname: Xiang
authors.affiliation: Department of Infectious Diseases and Hepatology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Liwen
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Infectious Diseases and Hepatology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Zhujun
authors.initials: Z
authors.lastname: Cao
authors.affiliation: Discipline of Anatomy and Histology F13, The University of Sydney, New South Wales, Australia.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Bao
authors.affiliation: Department of Infectious Diseases and Hepatology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Huijuan
authors.initials: H
authors.lastname: Zhou
authors.affiliation: Department of Infectious Diseases and Hepatology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Weiliang
authors.initials: W
authors.lastname: Tang
authors.affiliation: Department of Infectious Diseases and Hepatology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Lu
authors.affiliation: Department of Infectious Diseases and Hepatology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Lanyi
authors.initials: L
authors.lastname: Lin
authors.affiliation: Department of Infectious Diseases and Hepatology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Xie
authors.affiliation: Discipline of Pathology, School of Medical Sciences and Bosch Institute, The University of Sydney, New South Wales, Australia.
authors.forename: Shisan
authors.initials: S
authors.lastname: Bao
authors.affiliation: Department of Infectious Diseases and Hepatology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000188:drug therapy*; D004279:DNA, Viral / Q000097:blood; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006515:Hepatitis B virus; D019694:Hepatitis B, Chronic / Q000150:complications*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009705:Nucleosides / Q000737:chemistry*; D009711:Nucleotides / Q000737:chemistry*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D004279:DNA, Viral; D009705:Nucleosides; D009711:Nucleotides; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: chronic hepatitis B; hepatocellular carcinoma; nucleos(t)ide analogues; survival