核苷（酸）IDE模拟和肿瘤复发的乙肝病毒相关的肝癌射频消

StephenW

Hepatobiliary Malignancies
Association between nucleos(t)ide analog and tumor recurrence in hepatitis B virus–related hepatocellular carcinoma after radiofrequency ablation
Authors

    First published: 18 December 2015Full publication history
    DOI: 10.1002/hep.28266View/save citation
    Cited by: 1 articleRefresh citation countCiting literature
    Article has an altmetric score of 3

    Potential conflict of interest: Nothing to report.

    This work was supported, in part, by the National Health Research Institutes (PH-104-PP-23) and Taichung Veterans General Hospital (104DHA0500198), Taiwan.

    See Editorial on Page 1415

Abstract

Radiofrequency ablation (RFA) is the best choice for curative treatment of hepatocellular carcinoma (HCC) cases not suitable for surgical intervention, but efforts should be made to reduce the risk of tumor recurrence. We aimed to investigate the association between nucleos(t)ide analog (NA) therapy for hepatitis B virus (HBV) and the risk of HCC recurrence post-RFA. Using the Taiwan National Health Insurance Research Database between July 1, 2004 and December 31, 2012, we screened 48,807 patients with newly diagnosed HBV-related HCC. We identified 850 patients (200 patients who used NAs for more than 90 days and 650 who never used NA post-RFA) who received RFA as a potentially curative treatment for HCC. Patients in the NA-treated cohort were randomly matched 1:2 with patients in the untreated cohort by age, sex, cirrhosis, and the time period between RFA and initiation of NA therapy. Finally, 133 patients were recruited in the NA-treated group and 266 in the untreated group for analysis. Cumulative incidences of and hazard ratios (HRs) for HCC recurrence were analyzed after adjusting for competing mortality. The HCC recurrence rate of the NA-treated group was significantly lower than that of the untreated group (2-year recurrence rate: 41.8%; 95% confidence interval [CI]: 32.9-50.6 vs. 54.3%; 95% CI: 48.0-60.6; modified log-rank test: P < 0.05). In modified Cox's regression analysis, NA therapy was independently associated with a decreased risk of HCC recurrence (HR, 0.69; 95% CI: 0.50-0.95; P < 0.05). Multivariate stratified analyses verified the association of NA therapy and decreased HCC recurrence in almost all patient subgroups. Conclusion: NA therapy was associated with a decreased risk of HCC recurrence among patients with HBV-related HCC post-RFA. (Hepatology 2016;63:1517-1527)

StephenW

肝胆恶性肿瘤
核苷（酸）IDE模拟和肿瘤复发的乙肝病毒相关的肝癌射频消融治疗后的关联
作者

    首次出版：12月18日公布2015Full历史
    ：10.1002 / hep.28266View /保存引文
    1 articleRefresh引证文献countCiting：由引
    文章3的比分altmetric

    潜在的利益冲突：无报告。

    这项工作是支持的，一部分是由国家卫生研究院（PH-104-PP-23）和台中荣民总医院（104DHA0500198），台湾。

    见网页上编辑1415

抽象

射频消融（RFA）是用于治疗性治疗的肝细胞癌（HCC）的情况下不适合外科手术的最佳选择，但应努力，以减少肿瘤的复发的风险。我们的目的是探讨乙型肝炎病毒（HBV）和肝癌复发后RFA的风险，核苷（酸）类似物IDE（NA）治疗之间的关联。使用的是2004年7月1日和2012年12月31之间的台湾全民健康保险研究数据库，我们筛选48807例新诊断HBV相关肝癌。我们确定了850例患者谁收到RFA作为一个潜在的治愈性治疗肝癌（谁使用NAS进行90天以上和650谁从未使用后NA-RFA 200例）。在NA处理的队列患者随机匹配1:2与患者在年龄，性别，肝硬化未处理队列中，和射频消融和NA治疗开始之间的时间段。最后，133例患者中用于分析未处理组NA处理的组和266被招募。累计发生率和HCC复发的危险比（HR）调整竞争后的死亡率进行了分析。 NA处理组的HCC复发率明显高于未治疗组（2年复发率降低显著：41.8％; 95％的置信区间[CI]：32.9-50.6与54.3％; 95％CI：48.0 -60.6;修改后的日志秩检验P <0.05）。在修改考克斯的回归分析，NA治疗是独立与肝癌复发的风险降低（95％CI HR，0.69：0.50-0.95; P <0.05）。多因素分层分析证实NA治疗的协会，并在几乎所有的患者亚组降低肝癌复发。结论：NA治疗与HCC复发患者的HBV相关HCC后RFA之间的风险降低。 （2016年肝病; 63：1517年至1527年）