标题: the efficacy of anti-viral therapy in prevention of recurrence after curative tr [打印本页] 作者: StephenW 时间: 2011-3-25 19:19 标题: the efficacy of anti-viral therapy in prevention of recurrence after curative tr
Meta-analysis: the efficacy of anti-viral therapy in prevention of recurrence
after curative treatment of chronic hepatitis B-related hepatocellular carcinoma
J. S.-W. Wong1, G. L.-H. Wong2,3, K. K.-F. Tsoi2,3, V. W.-S. Wong2,3, S. Y.-S.
Cheung1, C.-N. Chong1, J. Wong1, K.-F. Lee1, P. B.-S. Lai1,2, H. L.-Y.
Chan2,3Article first published online: 24 MAR 2011
Alimentary Pharmacology & Therapeutics
Early View (Articles online in advance of print)
Summary
Background The role of anti-viral therapy in prevention of hepatocellular
carcinoma (HCC) recurrence is to be defined. Aim To investigate the role of
anti-viral therapy in prevention of tumour recurrence after curative treatment
of hepatitis B virus (HBV)-related HCC.
Methods A systematic electronic search on keywords including HCC and
different anti-viral therapies was performed through eight electronic databases,
including Medline, EMBASE and Cochrane Databases. The primary outcome was HCC
recurrence after curative treatment of HBV-related HCC. The secondary outcomes
were mortality related to HCC, mortality related to liver failure and the
overall mortality.
Results Nine cohort studies were included with a total number of 551
patients: 204 patients with anti-viral treatment group and 347 patients without
anti-viral treatment (control group). There was significant difference in the
incidence of HCC recurrence in favour of the anti-viral treatment group (55% vs.
58%; odds risk (OR) = 0.59, 95% CI 0.35–0.97, P = 0.04). The risk of HCC was
reduced by 41% in the anti-viral treatment group. There were also significant
differences in favour of anti-viral treatment group in terms of liver-related
mortality (0% vs. 8%; OR = 0.13, 95% CI 0.02–0.69, P = 0.02) and overall
mortality (38% vs. 42%; OR = 0.27, 95% CI 0.14–0.50, P < 0.001).
Conclusions Anti-viral therapy has potential beneficial effects after the
curative treatment of HBV-related hepatocellular carcinoma in terms of tumour
recurrence, liver-related mortality and overall survival. Anti-viral therapy
should be considered after curative treatment of hepatocellular carcinoma.