抗病毒治疗改善肝切除乙肝病毒相关性肝癌患者的生存

StephenW

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,*

Article first published online: 21 NOV 2014

DOI: 10.1111/apt.13034

© 2014 John Wiley & Sons Ltd

Issue
Cover image for Vol. 40 Issue 11-12
Alimentary Pharmacology & Therapeutics


    This article was accepted for publication after full peer-review.


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.

StephenW

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，*

文章首次在网上公布：2014年11月21日

DOI：10.1111/ apt.13034

©2014年约翰·威利父子有限公司

问题
封面图片的卷。 40期11-12
消化系统药理学与治疗学


    这篇文章被接受后，全面同行评审的出版物。


摘要
背景

在后切除长期生存患者的乙型肝炎病毒（HBV）的抗病毒治疗的效果 - 相关肝细胞癌（HCC）仍然不明朗。

目的

为了评价抗病毒治疗对后期肝切除生存和复发的患者HBV相关的肝癌的效果。

方法：

这是一个总的404例患者谁接受切除的HBV相关HCC的三级教学医院的前瞻性，回顾性研究。对患者和肿瘤特征，肿瘤复发，治疗复发和存活数据抗病毒药和没有抗病毒组之间进行比较。

结果

患者和肿瘤特征是可比两组之间，除了比例较高的肝硬化患者中的抗病毒组。与52.4个月，平均随访时间，抗病毒组有一个更好的5年生存率虽然有在5年无病生存率没有显著差异（66.7％对56.0％，P=0.001）（44.7 ％与38.1％，P =0.166）。使用抗病毒治疗中的溶液用在复发的时间，最好的肝功能保护区和较大比例的病人可以接受治愈性治疗复发（38.5％对24.3％，P =0.041）相关联。有患者谁开始抗病毒治疗之前或手术性（P =0.054）之后的危险比没有显著不同。

结论

使用抗病毒治疗可改善长期后肝切除患者的生存HBV相关的肝癌。随着复发的时间更好的肝功能储备，抗病毒组更大比例的病人可以得到根治性治疗的复发。