The Impact of Antivirus on Prognosis after Liver Resection for Hepatitis B-Related Hepatocellular Carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 TIANYun-hong , YANGHong-chun ,  PENGYong , MAHai , LIYong , LIGuan-yin

Department of Hepatobiliary Surgery, Nanchong Central Hospital, The Second Clinical Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China;

Corresponding author：

PENGYong, Email: drtianyunhong@126.com

Keywords：

Chronic hepatitis B; Liver resection; Hepatocellular carcinoma; Antiviral therapy; Nucleostide analogues

DOI：

10.7507/1007-9424.20150309

Video：

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Objective To observe the impact of antiviral therapy on prognosis in patients after curative resection for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Methods The data of 50 patients who had undergone liver resection for HBV-related HCC in our department from August 2008 to June 2012 were retrospectively analyzed. The patients were divided into two groups:21 patients who had not antiviral therapy (untreated group) and 29 patients who received antiviral therapy using nucleotide analogues (antiviral therapy group). Results After radical resection of HCC, the disease-free survival rate of 1-year, 3-year, and 5-year were 72.4%, 58.6%, and 31.0% in antiviral therapy group and 61.9%, 38.1%, and 14.3% in untreated group, respectively. The overall survival rate of 1-year, 3-year, and 5-year were 86.2%, 68.9%, and 55.2% in antiviral therapy group and 71.4%, 47.6%, and 28.6% in untreated group, respectively. The cumulative disease-free survival rate and overall survival rate of antiviral therapy group were significantly higher than those in the untreated group (P < 0.05). Univariate analysis revealed that the number of tumor, antiviral therapy, and TNM staging were risk factor for tumor-free survival rate, The tumor size, the number of tumor, antiviral therapy, and TNM staging were risk factor for overall survival rate. Multivariate analysis revealed that the number of tumor and TNM staging were independent risk factor for tumor-free survival rate (OR:2.95, 95% CI:1.502-6.114, P < 0.05; OR:4.12, 95% CI:1.972-8.960, P < 0.05), the antiviral therapy and TNM staging were independent risk factor for overall survival rate (OR:3.86, 95% CI:1.745-7.028, P < 0.05; OR:5.17, 95% CI:2.356-11.479, P < 0.05). Conclusion Using nucleotide analogs antiviral therapy may improve the prognosis after resection of patients with HBV-related HCC.

Citation： TIANYun-hong, YANGHong-chun, PENGYong, MAHai, LIYong, LIGuan-yin. The Impact of Antivirus on Prognosis after Liver Resection for Hepatitis B-Related Hepatocellular Carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(10): 1187-1191. doi: 10.7507/1007-9424.20150309 Copy

1.	Woo HY, Choi JY, Yoon SK, et al. Rescue therapy with adefovir in decompensated liver cirrhosis patients with lamivudine-resistant hepatitis B virus. Clin Mol Hepatol, 2014, 20(2):168-176.
2.	Wu CY, Lin JT, Ho HJ, et al. Association of nucleos(t)ide analogue therapy with reduced risk of hepatocellular carcinoma in patients with chronic hepatitis B:a nationwide cohort study. Gastroenterology, 2014, 147(1):143-151.
3.	Jang W, Yu SI, Sinn DH, et al. Longitudinal change of liver stiffness by transient elestography in chronic hepatitis B patients treated with nucleos(t)ide analogue. Clin Res Hepatol Gastroenterol, 2014, 38(2):195-200.
4.	Kim YJ, Kim K, Hwang SH, et al. Durability after discontinuation of nucleos (t) ide therapy in chronic HBeAg negative hepatitis patients. Clin Mol Hepatol, 2013, 19(3):300-304.
5.	Zoutendijk R, Reijnders JG, Zoulim F, et al. Virological response to entecavir is associated with a better clinical outcome in chronic hepatitis B patients with cirrhosis. Gut, 2013, 62(5):760-765.
6.	Edge SB, Compton CC. The American Joint Committee on Cancer:the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol, 2010, 17(6):1471-1474.
7.	Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin, 2011, 61(2):69-90.
8.	郝捷, 陈万青.中国肿瘤登记年报(2012).北京:军事医学科学出版社, 2012:27-60.
9.	戴朝六, 赵阳.原发性肝癌的综合治疗.中国普外基础与临床杂志, 2014, 21(2):133-137.
10.	Yang T, Lin C, Zhai J, et al. Surgical resection for advanced hepatocellular carcinoma according to Barcelona Clinic Liver Cancer (BCLC) staging. J Cancer Res Clin Oncol, 2012, 138(7):1121-1129.
11.	Piñero F, Mendizabal M, Casciato P, et al. Is recurrence rate of incidental hepatocellular carcinoma after liver transplantation similar to previously known HCC? towards a predictive recurrence score. Ann Hepatol, 2014, 13(2):211-218.
12.	Kawanaka M, Nishino K, Nakamura J, et al. Quantitative levels of hepatitis B virus DNA and surface antigen and the risk of hepatocellular carcinoma in patients with hepatitis B receiving long-term nucleos(t)ide analogue therapy. Liver Cancer, 2014, 3(1):41-52.
13.	Sohn W, Paik YH, Kim JM, et al. HBV DNA and HBsAg levels as risk predictors of early and late recurrence after curative resection of HBV-related hepatocellular carcinoma. Ann Surg Oncol, 2014, 21(7):2429-2435.
14.	Papatheodoridis GV, Lampertico P, Manolakopoulos S, et al. Incidence of hepatocellular carcinoma in chronic hepatitis B patients receiving nucleos(t)ide therapy:a systematic review. J Hepatol, 2010, 53(2):348-356.
15.	Hosaka T, Suzuki F, Kobayashi M, et al. HBcrAg is a predictor of post-treatment recurrence of hepatocellular carcinoma during antiviral therapy. Liver Int, 2010, 30(10):1461-1470.
16.	Huang G, Lau WY, Wang ZG, et al. Antiviral therapy improves postoperative survival in patients with hepatocellular carcinoma:a randomized controlled trial. Ann Surg, 2015, 261(1):56-66.
17.	Cheung YS, Chan HL, Wong J, et al. Elevated perioperative transaminase level predicts intrahepatic recurrence in hepatitis B-related hepatocellular carcinoma after curative hepatectomy. Asian J Surg, 2008, 31(2):41-49.
18.	Hung IF, Poon RT, Lai CL, et al. Recurrence of hepatitis B-related hepatocellular carcinoma is associated with high viral load at the time of resection. Am J Gastroenterol, 2008, 103(7):1663-1673.
19.	Kim BK, Park JY, Kim do Y, et al. Persistent hepatitis B viral replication affects recurrence of hepatocellular carcinoma after curative resection. Liver Int, 2008, 28(3):393-401.
20.	Wong JS, Wong GL, Tsoi KK, et al. Meta-analysis:the efficacy of anti-viral therapy in prevention of recurrence after curative treatment of chronic hepatitis B-related hepatocellular carcinoma. Aliment Pharmacol Ther, 2011, 33(10):1104-1112.
21.	Kuzuya T, Katano Y, Kumada T, et al. Efficacy of antiviral therapy with lamivudine after initial treatment for hepatitis B virus-related hepatocellular carcinoma. J Gastroenterol Hepatol, 2007, 22(11):1929-1935.
22.	Li N, Lai EC, Shi J, et al. A comparative study of antiviral therapy after resection of hepatocellular carcinoma in the immune-active phase of hepatitis B virus infection. Ann Surg Oncol, 2010, 17(1):179-185.
23.	Hosaka T, Suzuki F, Kobayashi M, et al. Development of HCC in patients receiving adefovir dipivoxil for lamivudine-resistant hepatitis B virus mutants. Hepatol Res, 2010, 40(2):145-152.
24.	Eun JR, Lee HJ, Kim TN, et al. Risk assessment for the development of hepatocellular carcinoma:according to on-treatment viral response during long-term lamivudine therapy in hepatitis B virusrelated liver disease. J Hepatol, 2010, 53(1):118-125.
25.	Vilarinho S, Calvisi DF. New advances in precision medicine for hepatocellular carcinoma recurrence prediction and treatment. Hepatology, 2014, 60(6):1812-1814.
26.	Kim MN, Han KH, Ahn SH, et al. Prevention of hepatocellular carcinoma:beyond hepatitis B vaccination. Semin Oncol, 2015, 42(2):316-328.

1. Woo HY, Choi JY, Yoon SK, et al. Rescue therapy with adefovir in decompensated liver cirrhosis patients with lamivudine-resistant hepatitis B virus. Clin Mol Hepatol, 2014, 20(2):168-176.
2. Wu CY, Lin JT, Ho HJ, et al. Association of nucleos(t)ide analogue therapy with reduced risk of hepatocellular carcinoma in patients with chronic hepatitis B:a nationwide cohort study. Gastroenterology, 2014, 147(1):143-151.
3. Jang W, Yu SI, Sinn DH, et al. Longitudinal change of liver stiffness by transient elestography in chronic hepatitis B patients treated with nucleos(t)ide analogue. Clin Res Hepatol Gastroenterol, 2014, 38(2):195-200.
4. Kim YJ, Kim K, Hwang SH, et al. Durability after discontinuation of nucleos (t) ide therapy in chronic HBeAg negative hepatitis patients. Clin Mol Hepatol, 2013, 19(3):300-304.
5. Zoutendijk R, Reijnders JG, Zoulim F, et al. Virological response to entecavir is associated with a better clinical outcome in chronic hepatitis B patients with cirrhosis. Gut, 2013, 62(5):760-765.
6. Edge SB, Compton CC. The American Joint Committee on Cancer:the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol, 2010, 17(6):1471-1474.
7. Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin, 2011, 61(2):69-90.
8. 郝捷, 陈万青.中国肿瘤登记年报(2012).北京:军事医学科学出版社, 2012:27-60.
9. 戴朝六, 赵阳.原发性肝癌的综合治疗.中国普外基础与临床杂志, 2014, 21(2):133-137.
10. Yang T, Lin C, Zhai J, et al. Surgical resection for advanced hepatocellular carcinoma according to Barcelona Clinic Liver Cancer (BCLC) staging. J Cancer Res Clin Oncol, 2012, 138(7):1121-1129.
11. Piñero F, Mendizabal M, Casciato P, et al. Is recurrence rate of incidental hepatocellular carcinoma after liver transplantation similar to previously known HCC? towards a predictive recurrence score. Ann Hepatol, 2014, 13(2):211-218.
12. Kawanaka M, Nishino K, Nakamura J, et al. Quantitative levels of hepatitis B virus DNA and surface antigen and the risk of hepatocellular carcinoma in patients with hepatitis B receiving long-term nucleos(t)ide analogue therapy. Liver Cancer, 2014, 3(1):41-52.
13. Sohn W, Paik YH, Kim JM, et al. HBV DNA and HBsAg levels as risk predictors of early and late recurrence after curative resection of HBV-related hepatocellular carcinoma. Ann Surg Oncol, 2014, 21(7):2429-2435.
14. Papatheodoridis GV, Lampertico P, Manolakopoulos S, et al. Incidence of hepatocellular carcinoma in chronic hepatitis B patients receiving nucleos(t)ide therapy:a systematic review. J Hepatol, 2010, 53(2):348-356.
15. Hosaka T, Suzuki F, Kobayashi M, et al. HBcrAg is a predictor of post-treatment recurrence of hepatocellular carcinoma during antiviral therapy. Liver Int, 2010, 30(10):1461-1470.
16. Huang G, Lau WY, Wang ZG, et al. Antiviral therapy improves postoperative survival in patients with hepatocellular carcinoma:a randomized controlled trial. Ann Surg, 2015, 261(1):56-66.
17. Cheung YS, Chan HL, Wong J, et al. Elevated perioperative transaminase level predicts intrahepatic recurrence in hepatitis B-related hepatocellular carcinoma after curative hepatectomy. Asian J Surg, 2008, 31(2):41-49.
18. Hung IF, Poon RT, Lai CL, et al. Recurrence of hepatitis B-related hepatocellular carcinoma is associated with high viral load at the time of resection. Am J Gastroenterol, 2008, 103(7):1663-1673.
19. Kim BK, Park JY, Kim do Y, et al. Persistent hepatitis B viral replication affects recurrence of hepatocellular carcinoma after curative resection. Liver Int, 2008, 28(3):393-401.
20. Wong JS, Wong GL, Tsoi KK, et al. Meta-analysis:the efficacy of anti-viral therapy in prevention of recurrence after curative treatment of chronic hepatitis B-related hepatocellular carcinoma. Aliment Pharmacol Ther, 2011, 33(10):1104-1112.
21. Kuzuya T, Katano Y, Kumada T, et al. Efficacy of antiviral therapy with lamivudine after initial treatment for hepatitis B virus-related hepatocellular carcinoma. J Gastroenterol Hepatol, 2007, 22(11):1929-1935.
22. Li N, Lai EC, Shi J, et al. A comparative study of antiviral therapy after resection of hepatocellular carcinoma in the immune-active phase of hepatitis B virus infection. Ann Surg Oncol, 2010, 17(1):179-185.
23. Hosaka T, Suzuki F, Kobayashi M, et al. Development of HCC in patients receiving adefovir dipivoxil for lamivudine-resistant hepatitis B virus mutants. Hepatol Res, 2010, 40(2):145-152.
24. Eun JR, Lee HJ, Kim TN, et al. Risk assessment for the development of hepatocellular carcinoma:according to on-treatment viral response during long-term lamivudine therapy in hepatitis B virusrelated liver disease. J Hepatol, 2010, 53(1):118-125.
25. Vilarinho S, Calvisi DF. New advances in precision medicine for hepatocellular carcinoma recurrence prediction and treatment. Hepatology, 2014, 60(6):1812-1814.
26. Kim MN, Han KH, Ahn SH, et al. Prevention of hepatocellular carcinoma:beyond hepatitis B vaccination. Semin Oncol, 2015, 42(2):316-328.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The Impact of Antivirus on Prognosis after Liver Resection for Hepatitis B-Related Hepatocellular Carcinoma

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