HBV-DNA负荷高的中期肝细胞癌患者可以从术后抗乙型肝炎病毒

StephenW

Medicine (Baltimore). 2017 Jul;96(30):e7608. doi: 10.1097/MD.0000000000007608.
Intermediate-stage hepatocellular carcinoma patients with a high HBV-DNA load may benefit from postoperative anti-hepatitis B virus therapy.Rui S1, Yan J, Zhang H, Wang Z, Zhou W.
Author information
1General Surgery Department 2, The First Hospital of Lanzhou University, Lanzhou, China.

AbstractLiver resection may be beneficial in intermediate-stage hepatocellular carcinoma (HCC), though the benefit of postoperative anti-hepatitis B virus (HBV) therapy in these patients remains unclear. In this study, we sought to evaluate the efficacy of postoperative anti-HBV for intermediate-stage HCC patients who underwent radical liver resection.According to inclusion and exclusion criteria, this study enrolled 202 HCC patients who underwent liver resection and had a high HBV-DNA load. The patients were divided into 2 groups on the basis of postoperative anti-HBV therapy: group A included patients undergoing postoperative anti-HBV therapy, whereas group B patients did not receive any postoperative anti-HBV therapy. Factors including baseline demographics, tumor characteristics, overall long-term survival, tumor-free survival, and tumor recurrence rate were compared between the 2 groups. Moreover, univariate and multivariate analyses were used to identify risk factors of HCC recurrence.Baseline demographics and tumor characteristics were comparable between the groups. The 1-, 3-, and 5-year overall survival rates in group A were 91.3%, 80.9%, and 66.1%, respectively, values that were significantly increased compared with group B (91.7%, 60.7%, and 52.4%, respectively, P = .019). Group A patients also exhibited enhanced 1-, 3-, and 5-year tumor-free survival compared with group B patients (87.0%, 67.0%, and 62.6%, respectively, in group A; 82.1%, 50.0%, and 42.9% in group B, P = .002). In addition, the tumor recurrence rate in group B was significantly increased compared with group A (P < .01). Univariate and multivariate analyses indicated lack of postoperative anti-HBV therapy [hazard ratio (HR) = 0.882; 95% confidence interval (CI), 0.712-0.938; P = .042] to be a predictor of tumor recurrence.For intermediate-stage [Barcelona Clinic Liver Cancer (BCLC) stage B] HCC with a high HBV-DNA load, postoperative anti-HBV therapy after curative resection should be routine adjuvant therapy.


PMID:28746212DOI:10.1097/MD.0000000000007608

StephenW

医学（巴尔的摩）。 2017年7月; 96（30）：e7608。 doi：10.1097 / MD.0000000000007608。
HBV-DNA负荷高的中期肝细胞癌患者可以从术后抗乙型肝炎病毒治疗中受益。
芮S1，严杰，张昊，王泽，周伟
作者信息

1
    兰州大学第一医院普外科2，兰州，中国。

抽象

肝切除可能对中期肝细胞癌（HCC）有好处，但这些患者术后抗乙型肝炎病毒（HBV）治疗的益处尚不清楚。本研究旨在评估术后抗HBV对中晚期肝切除患者的疗效。根据纳入和排除标准，本研究纳入了202例肝切除肝切除患者， DNA负载。在术后抗HBV治疗的基础上将患者分为2组：A组包括进行术后抗HBV治疗的患者，而B组患者未接受任何术后抗HBV治疗。比较两组之间的基线人口统计学特征，肿瘤特征，总体长期生存率，无瘤生存率和肿瘤复发率等因素。此外，单变量和多变量分析用于鉴定HCC复发的危险因素。各组之间的线性人口统计学和肿瘤特征是可比较的。 A组1〜3年，5年总生存率分别为91.3％，80.9％和66.1％，与B组比较，差异有统计学意义（91.7％，60.7％，52.4％分别为P = 0.019）。 A组患者与B组患者相比，具有增加的1年，3年和5年无瘤生存率（A组分别为87.0％，67.0％和62.6％; 82.1％，50.0％和42.9％ B组为P，P = .002）。另外B组肿瘤复发率明显高于A组（P <0.01）。单因素和多变量分析显示术后抗HBV治疗缺乏[危险比（HR）= 0.882; 95％置信区间（CI），0.712-0.938; P = 0.042]作为肿瘤复发的预测因子。对于中期阶段（巴塞罗那诊所肝癌（BCLC）阶段B）具有高HBV-DNA负荷的HCC，治疗性切除术后术后抗HBV治疗应为常规辅助治疗。

结论：
    28746212
DOI：
    10.1097 / MD.0000000000007608

StephenW

http://journals.lww.com/md-journ ... r_carcinoma.43.aspx