title: HBV is a risk factor for poor patient prognosis after curative resection of hepatocellular carcinoma: A retrospective case-control study.
abstract: Controversy exists regarding pathological factors affecting the prognosis of hepatocellular carcinoma (HCC) patients with hepatitis B virus (HBV-HCC). Their postoperative clinical behaviors and the exact HBV Deoxyribonucleic Acid (DNA) thresholds that distinguish good and poor prognoses are unknown. This study aimed to compare clinicopathological, pre- and postoperative clinical factors and overall and recurrence-free survival (RFS) between HBV-HCC patients and nonhepatitis B and nonhepatitis C HCC (NBC-HCC) patients to determine the optimal prognostic HBV DNA threshold.Data from 1440 patients with HBV-HCC and NBC-HCC who underwent curative hepatectomy were retrospectively analyzed.Liver function in the HBV-HCC group was significantly worse than in the NBC-HCC group. Compared with NBC-HCC patients, HBV-HCC patients had significantly more vascular invasion and advanced HCC. The HBV-HCC patients also had significantly worse liver function and more complications. Further survival analysis showed significantly lower overall and RFS rates and a higher early recurrence rate in the HBV-HCC group. Univariate analysis indicated that HBV was a risk factor for overall and RFS. Finally, X-tile analysis revealed that the optimal HBV DNA cutoff points for predicting RFS and overall survival in HCC patients were 10,100 and 12,800 IU/mL, respectively.After hepatectomy for HCC, HBV-HCC patients had more complications and a worse prognosis than NBC-HCC patients. Antiviral therapy should be considered before hepatectomy in patients with high (more than approximately 10 IU/mL) HBV DNA levels.
authors: Hepatobiliary Surgery Institute, Southwest Hospital, Third Military Medical University, China.
authors: Zhonghu
authors: Z
authors: Li
authors: Xin
authors: X
authors: Zhao
authors: Peng
authors: P
authors: Jiang
authors: Senlin
authors: S
authors: Xiao
authors: Guo
authors: G
authors: Wu
authors: Kai
authors: K
authors: Chen
authors: Xi
authors: X
authors: Zhang
authors: Hui
authors: H
authors: Liu
authors: Xiuguo
authors: X
authors: Han
authors: Shuguang
authors: S
authors: Wang
authors: Xiaowu
authors: X
authors: Li
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000821:virology*; D016022:Case-Control Studies; D002681:China; D004279:DNA, Viral / Q000032:analysis; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods / Q000401:mortality; D006509:Hepatitis B / Q000150:complications* / Q000175:diagnosis; D006515:Hepatitis B virus / Q000302:isolation & purification; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis; D006801:Humans; D053208:Kaplan-Meier Estimate; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D004279:DNA, Viral