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A high baseline HBV load and antiviral therapy affect the survival of patients with advanced HBV-related HCC treated with sorafenib
Yu Yang1,†, Feng Wen1,†, Jianliang Li2,†, Pengfei Zhang1,†, Wenhui Yan3, Ping Hao4, Feng Xia5, Feng Bi1 andQiu Li1,*
Article first published online: 7 MAR 2015
DOI: 10.1111/liv.12805
© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Issue
Liver International
Volume 35, Issue 9, pages 2147–2154, September 2015
1 The Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
2 The Department of Medical Oncology, Hunan Cancer Hospital/The Affiliated Tumor Hospital of Xiangya School of Medicine, Central South University, Changsha, China
3 The Department of Medical Oncology, Second People's Hospital of Hunan Province, Changsha, China
4 The Department of Oncology, Xinqiao Hospital, The Third Military Medical University, Chongqing, China
5 The Department of Hepatobiliary Surgery, Southwest Hospital, Chongqing, China
† These authors contributed equally to this work.
* Correspondence
Dr. and Prof. Q. Li, The Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, Sichuan 610041, China
Tel: +86 28 85423609
Fax: +86 28 85423262
e-mail: [email protected]
Keywords:
antiviral therapy;hepatitis B;hepatocellular carcinoma;sorafenib;viral load
Abstract
Background and Aims
Although a high viral load is an independent risk factor for recurrence of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after surgery, the prognostic impact of viral load on advanced HCC is unclear. This study investigated the impact of baseline HBV load and antiviral therapy on survival of patients with advanced HCC treated with sorafenib.
Methods
Of 130 patients with advanced HBV-related HCC received first-line sorafenib therapy were evaluated in a multicenter, retrospective study.
Results
No patients experienced severe hepatic impairment because of HBV reactivation during sorafenib therapy. The median progression-free survival (PFS) and overall survival (OS) of all patients were 5.7 and 9.6 months respectively. Patients with a baseline HBV DNA ≤104 copies/ml had significantly better OS than those with >104 copies/ml (10.4 vs 6.6 months; P = 0.002), but PFS showed an increasing trend (5.8 vs 4.8 months; P = 0.068). Patients who received antiviral therapy had a better trend in OS than those who did not (12.0 vs 8.3 months; P = 0.058), but there was no difference in PFS (6.4 vs 4.1 months; P = 0.280). In a multivariate analysis, the baseline HBV DNA level >104 copies/ml (P = 0.001; hazard ration [HR] = 2.294; 95% CI 1.429–3.676) and antiviral therapy (P = 0.038; HR 0.617; 95% CI 0.390–0.975) were independent predictors of OS.
Conclusion
In patients with advanced HBV-related HCC treated with sorafenib, a high baseline HBV load was an adverse prognostic factor for survival. However, survival was significantly improved with the use of antiviral therapy.
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