EASL2020[AS094] 替诺福韦vs恩替卡韦治疗术后无复发和 乙型肝炎

StephenW

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.

StephenW

AS094
替诺福韦vs恩替卡韦治疗术后无复发和
乙型肝炎病毒相关患者的总体生存
肝细胞癌
崔钟基1，陈荣乔2，林淑淑1。 1阿三医疗中心
蔚山大学医学院胃肠病学系
韩国首尔，南方共和国； 2蔚山大学亚山医学中心
韩国首尔医学院内科系
南方共和国
电子邮件：[email protected]
背景和目的：研究表明替诺福韦
富马酸迪索罗酯（TDF）治疗与显着相关
降低肝细胞癌（HCC）发生的风险
与恩替卡韦治疗慢性乙型肝炎患者相比。我们
旨在比较替诺福韦和恩替卡韦的无复发率和
乙型肝炎根治性肝切除术后患者的总体生存率
病毒（HBV）相关的HCC。
方法：这项历史队列研究包括1,695份连续研究
恩替卡韦（n = 813）或TDF（n = 882）治疗的患者
根治性肝切除术后BCLC 0或A期与HBV相关的HCC
2010年至2018年在韩国。无复发和总体生存
根据倾向比较了恩替卡韦和替诺福韦组
得分（PS）匹配和多变量调整的Cox回归
分析。
结果：在研究的患者中，平均年龄为54.8岁和1,294岁
患者（76.3％）为男性。随访的中位数为37.6
几个月。与恩替卡韦相比，替诺福韦疗法具有相关性
PS匹配可显着降低HCC复发率
对567对患者（P = 0.02）和多变量校正后的结果进行分析
整个患者的分析（危险比[HR]为0.82； 95％CI为0.68–
0.98; P = 0.03；数字）。总死亡率也大大降低
替诺福韦组与恩替卡韦组比较
分析（P = 0.03）和多变量分析（HR，0.62； 95％CI，0.44–
0.88； P = 0.01）。替诺福韦疗法是一种独立的保护性药物
早期（<2年； HR，0.79； 95％CI，0.64-0.97； P = 0.03）的影响因素
和晚期（≥2年； HR，0.68； 95％CI，0.47-0.97； P = 0.03）HCC
复发。
结论：在接受根治性肝切除术的患者中
乙肝相关肝癌，替诺福韦治疗与显着相关
与之相比，无复发和总体生存率更高
恩替卡韦治疗。