Dig Dis Sci. 2018 Aug 23. doi: 10.1007/s10620-018-5252-8. [Epub ahead of print]
Efficacy of Nucleoside Analogs for Chronic Hepatitis B Virus-Related Hepatocellular Carcinoma After Curative Treatment: A Meta-Analysis.
Zhang G1, Yu X2, Liu P1, Huang X1, Jiang X3.
Author information
1
Department of Gastroenterology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, 43 People's Avenue, Haikou, 570028, China.
2
Department of Gastroenterology, Zhongshan Hospital of Fudan University, 180 Fenglin Rd., Shanghai, 200032, China.
3
Department of Gastroenterology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, 43 People's Avenue, Haikou, 570028, China. [email protected].
Abstract
BACKGROUND AND AIM:
The efficacy of nucleoside analogs (NAs) for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after curative treatment remains unclear. The present study aimed to evaluate the efficacy of these agents by conducting a comprehensive meta-analysis of available studies.
METHODS:
We searched several databases including Pubmed, Embase, Cochrane Library, Clinical Trials, and Web of Science, according to PRISMA guidelines. We considered all randomized controlled trials and cohort studies that met the inclusion criteria. Statistical analyses were conducted using Review Manager 5.3 and Stata 14.0.
RESULTS:
Twenty-one studies with 8752 participants were included in the final analysis. The pooled data showed that patients treated with NAs had significantly lower 1- and 3-year HCC recurrence rates (relative risk [RR] 0.76, 95% confidence interval [CI] 0.65-0.90; P = 0.001 and RR 0.79, 95% CI 0.71-0.88; P < 0.001, respectively), but there was no difference in 5-year recurrence rates (RR 0.87, 95% CI 0.74-1.03; P = 0.10). Regarding overall survival (OS), patients treated with NAs had significantly higher 1-, 3-, and 5-year OS rates (RR 1.05, 95% CI 1.02-1.08; P = 0.003; RR 1.25, 95% CI 1.16-1.34; P < 0.001; and RR 1.28, 95% CI 1.18-1.39; P < 0.001, respectively).
CONCLUSION:
NA therapy has the potential to reduce the risk of early recurrence and improve OS in patients with HBV-related HCC after curative treatment, compared with placebo or no treatment. Further research including more homogeneous studies with large sample sizes is required to improve the reliability of these conclusions.
KEYWORDS:
Curative treatment; Hepatocellular carcinoma; Meta-analysis; Nucleoside analog