Effects of antiviral therapy on long-term outcome after liver resection for hepa

StephenW

J Hepatobiliary Pancreat Sci. 2011 Dec 28.
Source: http://www.ncbi.nlm.nih.gov/pubmed/22203455
Effects of antiviral therapy on long-term outcome after liver resection for
hepatitis B virus-related hepatocellular carcinoma. Urata Y, Kubo S,
Takemura S, Uenishi T, Kodai S, Shinkawa H, Sakae M, Kaneda K, Ohata K,
Nozawa A, Suehiro S. SourceDepartment of Hepato-Biliary-Pancreatic Surgery,
Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi,
Abeno-ku, Osaka, 545-8585, Japan, [email protected].

Abstract
BACKGROUND/PURPOSE: We investigated the effects of nucleos(t)ide analogues
(NAs) on long-term outcome in patients following curative treatment for
hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).

METHODS: This study involved 70 of the 76 patients who had undergone liver
resection for HBV-related HCC in our department; 6 patients were excluded
due to non-curative resection or advanced cancer. The 70 patients were
divided into three groups, as follows: 13 patients with high serum
concentration of HBV DNA (?4 log(10) copies/mL) and no antiviral therapy
(high viral group); 46 patients who received antiviral therapy during the
serial follow up (antiviral therapy group) because of high viral
concentration (?4 log(10) copies/mL); and 11 patients with low serum
concentration of HBV DNA (<4 log(10) copies/mL) and no antiviral therapy
(low viral group).

RESULTS: Tumor-free survival rate was significantly higher in the low viral
group than in the high viral group (P = 0.0058). Multivariate analysis
revealed that a high serum concentration of HBV DNA (?4 log(10) copies/mL)
(risk ratio 6.717, 95% confidence interval 1.435-31.434, P = 0.0156) was an
independent risk factor for a short tumor-free survival time. Tumor-free
survival rate was significantly higher in the antiviral therapy group than
in the high viral group (P = 0.0478). Multivariate analysis revealed that
presence of multiple tumors (risk ratio 2.857, 95% confidence interval
1.403-5.816, P = 0.0038) was an independent risk factor for a short
tumor-free survival time. The cumulative survival rate was significantly
higher in the antiviral therapy group than in the high viral group (P =
0.0025). Multivariate analysis revealed that not undergoing antiviral
therapy (risk ratio 0.121, 95% confidence interval 0.024-0.608, P = 0.0104)
was an independent risk factor for a short survival time.

CONCLUSIONS: A high serum concentration of HBV DNA (?4 log(10) copies/mL)
was a strong risk factor for HCC recurrence after resection of HBV-related
HCC. Antiviral therapy with NAs improved the long-term outcome after
resection of HBV-related HCC in patients with high serum concentrations of
HBV DNA.



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StephenW

J肝胆Pancreat科学。 2011年12月28日。
资料来源：http://www.ncbi.nlm.nih.gov/pubmed/22203455
抗病毒治疗对肝切除后的长期结果
乙肝病毒相关性肝细胞癌。 Y，浦田久保小号，
竹村荣中号Uenishi T，Kodai小号，新川H，S，K，金田Ohata K，
野泽一个，末广S. SourceDepartment肝胆胰外科，
大阪市立大学研究生院医学，1-4-3 Asahimachi，
阿倍野区，大阪545-8585，日本，[email protected]。

摘要
背景/目的：我们调查的核苷（酸）IDE类似物的影响
（NAS）对患者的长期结果根治性治疗
B型肝炎病毒（HBV）相关肝细胞癌（HCC）。

方法：本研究涉及的76个经历了肝患者70
我们的部门在HBV相关HCC的切除; 6例患者均排除
由于非根治性切除或晚期癌症。 70例患者
分为三组，具体如下：高血清13例
HBV DNA的浓度（4日志（10）拷贝/ mL）和没有抗病毒治疗
（高病毒组）;期间收到的抗病毒药物治疗的46例
串行跟进（抗病毒治疗组），因为高病毒
的浓度（4日志（10）拷贝/ mL？）;和低血清11例
浓度的HBV DNA（<4日志（10）拷贝/ mL）和没有抗病毒治疗
（低病毒组）。

结果：无瘤生存率明显低病毒
组比在高病毒组（P = 0.0058）。多因素分析
显示，高血药浓度的HBV DNA（4日志（10）拷贝/ ml）
（风险比为6.717，95％可信区间为1.435-31.434，P = 0.0156）
很短的无瘤生存时间的独立危险因素。无瘤
成活率在抗病毒药物治疗组显著高于
在病毒组高（P = 0.0478）。多变量分析显示
存在多个肿瘤（风险比为2.857，95％置信区间
1.403-5.816，P = 0.0038）是一个很短的独立危险因素
无瘤生存时间。累积生存率显着
在抗病毒药物治疗组高于高病毒组（P <
0.0025）。多变量分析显示，未接受抗病毒药物
治疗（风险比为0.121，95％可信区间0.024-0.608，P = 0.0104）
是一个很短的生存时间的独立危险因素。

结论：血清HBV DNA的高浓度（4日志（10）拷贝/ mL？）
HBV相关性切除后是一个强大的HCC复发的危险因素
肝癌。与NAS的抗病毒治疗后改善长期的结果
HBV相关肝癌切除患者的血药浓度高
HBV - DNA。