title: Efficacy of Nucleot(s)ide Analogs Therapy in Patients with Unresectable HBV-Related Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis.
abstract: Aim. To determine whether nucleot(s)ide analogs therapy has survival benefit for patients with HBV-related HCC after unresectable treatment.Method. A systematic search was conducted through seven electronic databases including PubMed, OVID, EMBASE, Cochrane Databases, Elsevier, Wiley Online Library, and BMJ Best Practice. All studies comparing NA combined with unresectable treatment versus unresectable treatment alone were considered for inclusion. The primary outcome was the overall survival (OS) after unresectable treatment for patients with HBV-related HCC. The secondary outcome was the progression-free survival (PFS). Results were expressed as hazard ratio (HR) for survival with 95% confidence intervals.Results. We included six studies with 994 patients: 409 patients in nucleot(s)ide analogs therapy group and 585 patients without antiviral therapy in control group. There were significant improvements for the overall survival (HR = 0.57; 95% CI = 0.47-0.70;p< 0.001) and progression-free survival (HR = 0.84; 95% CI = 0.71-0.99;p= 0.034) in the NA-treated group compared with the control group. Funnel plot showed that there was no significant publication bias in these studies. When it comes to antiviral drugs and operation method, it also showed benefit in NA-treated group. At the same time, overall mortality as well as mortality secondary to liver failure in NA-treated group was obviously lesser. Sensitivity analyses confirmed the robustness of the results.Conclusions. Nucleot(s)ide analogs therapy after unresectable treatment has potential beneficial effects in terms of overall survival and progression-free survival. NA therapy should be considered in clinical practice.
authors.affiliation: Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.
authors.forename: Lingling
authors.initials: L
authors.lastname: He
authors.affiliation: Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Liu
authors.affiliation: Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.
authors.forename: Yalin
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.
authors.forename: Shuan
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.
authors.forename: Yuyong
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.
authors.forename: Xianbo
authors.initials: X
authors.lastname: Wang
authors.affiliation: Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China; Collaborative Innovation Center of Infectious Diseases, Capital Medical University, Chaoyang, Beijing 10015, China.
authors.forename: Zhiyun
authors.identifier: 0000-0002-1522-0749
authors.initials: Z
authors.lastname: Yang
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D001086:Arabinofuranosyluracil / Q000031:analogs & derivatives / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D006147:Guanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D006515:Hepatitis B virus / Q000187:drug effects* / Q000254:growth & development / Q000472:pathogenicity; D019694:Hepatitis B, Chronic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D063065:Organophosphonates / Q000627:therapeutic use; D012189:Retrospective Studies; D016019:Survival Analysis; D000077712:Telbivudine; D000068698:Tenofovir / Q000627:therapeutic use; D013936:Thymidine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D063065:Organophosphonates; D000077712:Telbivudine; D019259:Lamivudine; D001086:Arabinofuranosyluracil; C413685:entecavir; D006147:Guanine; C053001:adefovir; D000068698:Tenofovir; C034935:clevudine; D000225:Adenine; D013936:Thymidine