Antiviral therapy improves post-hepatectomy survival in patients with hepatitis B virus-related hepatocellular carcinoma: a prospective-retrospective study
C. C. N. Chong1,
G. L. H. Wong2,3,
V. W. S. Wong2,3,
P. C. T. Ip1,
Y. S. Cheung1,
J. Wong1,
K. F. Lee1,
P. B. S. Lai1 and
H. L. Y. Chan2,3,*
1 Division of Hepato-biliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
2 Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
3 State Key Laboratory of Digestive Disease, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
* Correspondence to:
Prof. H. Chan, Department of Medicine and Therapeutics, 9⁄F Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, Hong Kong
E-mail: [email protected]
Summary
Background
The effect of antiviral therapy on the post-hepatectomy long-term survival in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) remains uncertain.
Aim
To evaluate the effect of antiviral therapy on post-hepatectomy survival and recurrence in patients with HBV-related HCC.
Methods
This was a prospective-retrospective study of a total of 404 patients who underwent hepatectomy for HBV-related HCC in a tertiary academic hospital. Data on patient and tumour characteristics, tumour recurrence, treatment for recurrence and survival were compared between antiviral and no antiviral groups.
Results
Patient's and tumour characteristics were comparable between the two groups, except a higher proportion of patients with cirrhosis in the antiviral group. With a mean follow-up time of 52.4 months, antiviral group had a better 5-year overall survival (66.7% vs. 56.0%, P = 0.001) while there was no significant difference in the 5-year disease-free survival (44.7% vs. 38.1%, P = 0.166). Use of antiviral therapy was associated with better liver function reserve at the time of recurrence and a greater proportion of patients could receive curative treatment for recurrence (38.5% vs. 24.3%, P = 0.041). There was no significant different in the hazard ratios of patients who started antiviral therapy before or after operation (P = 0.054).
Conclusions
Use of antiviral therapy improves the long-term post-hepatectomy survival in patients with HBV-related HCC. With a better liver function reserve at the time of recurrence, a greater proportion of patients in antiviral group could receive curative treatment for recurrence.
作者: StephenW 时间: 2014-12-18 21:08
抗病毒治疗改善后肝切除患者的生存乙肝病毒相关性肝癌的前瞻性，回顾性研究
C. C. N. Chong1，
G. H. L. Wong2,3，
V. W. S. Wong2,3，
P. C. T.为Ip1，
Y. S. Cheung1，
J. Wong1，
K. F. Lee1，
P. B. S. Lai1和
H. L. Y. Chan2,3，*