Perioperative antiviral therapy improves the prognosis of HBV DNA-negative patients with HBV-related hepatocellular carcinoma
Chuan Li , Zhi-Cheng Li , Liang Ma , Le-Qun Li , Jian-Hong Zhong ORCID Icon, Bang-De Xiang & show all
Received 27 Mar 2020, Accepted 16 Jun 2020, Accepted author version posted online: 18 Jun 2020
To investigate the effect of perioperative antiviral therapy on the prognosis of hepatitis B virus (HBV) DNA-negative patients with HBV-related hepatocellular carcinoma (HCC).
Methods
The clinical data of 140 patients who were positive for hepatitis B surface antigen (HBsAg) but negative for HBV DNA before partial hepatectomy were retrospectively analyzed. Patients who received perioperaive antiviral therapy were divided into the antiviral therapy group, and those who did not receive any antiviral therapies were divided into the non-antiviral therapy group. Propensity score matching (PSM) was used to match patients 1:1 to eliminate the influence of confounding factors on prognosis. Postoperative liver function, HBV reactivation rate, recurrence-free survival (RFS) and overall survival (OS) were compared between the two groups. After excluding patients with HBV reactivation, the prognostic analysis of the samples was conducted again, and then to observe whether perioperative antiviral therapy was effective for these patients who did not have HBV reactivation after partial hepatectomy.
Results
A total of 140 patients were included in this study, including 60 in the antiviral therapy group and 80 in the non-antiviral therapy group. Compared with the non-antiviral therapy group, the antiviral therapy group had a lower rate of HBV reactivation and better postoperative liver function (P < 0.05). The 1-year, 2-year and 3-year survival rates of the antiviral therapy group were better than those of the non-antiviral therapy group before or after PSM (P < 0.05). Prognostic analysis excluding 11 patients with HBV reactivation showed that perioperative antiviral therapy could significantly improve OS (P = 0.004), but had no significant effect on RFS (P = 0.056). Multivariate analyses showed that microvascular invasion (MVI) was the only independent risk factor for tumor recurrence, and antiviral therapy was associated with OS.
Conclusion
Perioperative antiviral therapy can significantly reduce the risk of HBV reactivation and improve postoperative liver function, and also significantly improve RFS and OS.
Keywords: Hepatocellular carcinoma, Hepatectomy, Prognosis, Overall survival, Hepatitis B, HBV DNA
Additional information
Funding
This work was funded by the Guangxi Natural Science Foundation (14124003-4), the National Science and Technology Major Special Project (2017ZX10203207), the National Natural Science Foundation of China (81160262, 81260088), the Guangxi Medical and Health Appropriate Technology Development and Promotion Application Project (S2019045), the Self-Raised Scientific Research Fund of the Ministry of Health of Guangxi Province (grant number Z2015601), and the ‘Guangxi BaGui Scholars’ Special Fund.
Authors’ contributions
W Gong and B Xiang conceived the study. C Li and Z Li collected and analyzed the data. C Li drafted the manuscript. L Ma, B Xiang, J Zhong and L Li critically revised the manuscript. All authors have read and approved the final version to be published.
Conflicts of Interest
The authors have declared that no competing interests exist.
Declaration of interest
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
Reviewer disclosures
Peer reviewers on this manuscript have no relevant financial or other relationships to
disclose.
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Format-free submission 作者: StephenW 时间: 2020-6-20 11:58
A total of 140 patients were included in this study, including 60 in the antiviral therapy group and 80 in the non-antiviral therapy group. Compared with the non-antiviral therapy group, the antiviral therapy group had a lower rate of HBV reactivation and better postoperative liver function (P < 0.05). The 1-year, 2-year and 3-year survival rates of the antiviral therapy group were better than those of the non-antiviral therapy group before or after PSM (P < 0.05). Prognostic analysis excluding 11 patients with HBV reactivation showed that perioperative antiviral therapy could significantly improve OS (P = 0.004), but had no significant effect on RFS (P = 0.056). Multivariate analyses showed that microvascular invasion (MVI) was the only independent risk factor for tumor recurrence, and antiviral therapy was associated with OS.作者: 挚友888888 时间: 2020-6-20 15:35
The 1-year, 2-year and 3-year survival 抗病毒治疗组的1年,2年和3年生存率,失败以后还可以换药吗?还是game is over。