AS094
Tenofovir vs entecavir on post-operative recurrence-free and
overall survival of patients with hepatitis B virus-related
hepatocellular carcinoma
Jonggi Choi1, Chanyoung Jo2, Young-Suk Lim1. 1Asan Medical Center,
University of Ulsan College of Medicine, Department of Gastroenterology,
Seoul, Korea, Rep. of South; 2Asan Medical Center, University of Ulsan
College of Medicine, Department of Internal Medicine, Seoul, Korea,
Rep. of South
Email: [email protected]
Background and Aims: Studies have suggested that tenofovir
disoproxil fumarate (TDF) treatment was associated with a significantly
lower risk of hepatocellular carcinoma (HCC) occurrence
compared to entecavir therapy in chronic hepatitis B patients. We
aimed to compare tenofovir and entecavir on the recurrence-free and
overall survival of patients after curative hepatectomy for hepatitis B
virus (HBV)-related HCC.
Method: This historical cohort study included 1,695 consecutive
patients who were treated with entecavir (n = 813) or TDF (n = 882)
after curative hepatectomy for HBV-related HCC of BCLC stage 0 or A
in Korea between 2010 and 2018. Recurrence-free and overall survival
were compared between entecavir and tenofovir groups by propensity
score (PS)-matched and multivariable-adjusted Cox regression
analyses.
Results: Of the study patients, mean age was 54.8 years and 1,294
patients (76.3%) were male. Median duration of follow-up was 37.6
months. Compared with entecavir, tenofovir therapy was associated
with a significantly lower rate of HCC recurrence by PS-matched
analysis of 567 pairs of patients (P = 0.02) and multivariable-adjusted
analysis of the entire patients (hazard ratio [HR], 0.82; 95% CI, 0.68–
0.98; P = 0.03; Figure). Overall mortality was also significantly lower
in the tenofovir group compared with entecavir group by PS-matched
analysis (P = 0.03) and multivariable analysis (HR, 0.62; 95% CI, 0.44–
0.88; P = 0.01). Tenofovir therapy was an independent protective
factor for both early (<2 years; HR, 0.79; 95% CI, 0.64–0.97; P = 0.03)
and late ( ≥ 2 years; HR, 0.68; 95% CI, 0.47–0.97; P = 0.03) HCC
recurrence.
Conclusion: Among patients who undergo curative hepatectomy for
HBV-related HCC, tenofovir therapy was associated with significantly
better recurrence-free and overall survival rate compared with
entecavir therapy. 作者: StephenW 时间: 2020-8-24 13:32