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Impact of Preoperative Hepatitis B Virus Levels on Prognosis After Primary and Repeat Hepatectomies for Hepatocellular Carcinoma Patients—a Retrospective Study

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Chronic HBV plays an important role in hepatocellular carcinoma pathogenesis. Previously, most studies have been focusing on HBV DNA levels before the primary curative hepatectomy. However, the association of virus level before repeat hepatectomy with the degrees of inflammation and fibrosis on histopathology and prognosis has not been surveyed.

Methods

From January 2002 to December 2009, all patients who were seropositive for hepatitis B surface antigen (HBsAg) were enrolled and assigned into four groups based on their HBV DNA levels before the primary and repeat hepatectomies. The cancer prognoses of these four groups of patients after the first and second operations were assessed and compared. The disease-free survival and overall survival were estimated by the Kaplan-Meier method. Univariate and multivariate analyses were performed to identify risk factors for the primary and repeat hepatectomies.

Results

For the 385 patients in this study, a low level of serum HBV DNA before repeat hepatectomy, but not primary hepatectomy, was significantly associated with improvement in prognosis, in terms of tumor recurrence, liver fibrosis, and liver-related mortality.

Conclusion

The levels of HBV DNA before hepatectomies were crucial prognostic risk factors of HBV-related hepatocellular carcinoma patients. Surveillance of serum HBV DNA levels at multiple time points, rather than at a single time point, and antiviral therapy to suppress the virus to a low level had beneficial effects for these patients.

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Funding

This work was supported by the National Key Basic Research and Development Program of China (2014CB542102), Creative Research Groups Grant (81221061), and the National Natural Science Foundation of China (81372207 and 81402318).

Author information

Author notes

  1. Pin-Gao Yan and Ruo-Yu Wang contributed equally.

Authors and Affiliations

  1. The Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China

    Pin-Gao Yan, Ruo-Yu Wang, Jin Zhang, Meng-Chao Wu & Wei-Ping Zhou

  2. The Department of Breast Surgery, Chongqing University Cancer Hospital & Chongqing Cancer Institute, Chongqing, China

    Pin-Gao Yan

  3. The Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

    Pin-Gao Yan

  4. The Department of Pathology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China

    Wen-Ming Cong & Hui Dong

  5. The Department of Pathology, Chang Zheng Hospital, Second Military Medical University, Shanghai, China

    Hong-Yu Yu

  6. Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China

    Wan Yee Lau

Authors
  1. Pin-Gao Yan
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Contributions

Conception and design: Pin-Gao Yan, Ruo-Yu Wang, Meng-Chao Wu, Wei-Ping Zhou

Collection of patients’ data: Jin Zhang and Wen-Ming Cong

Data acquisition, analysis, and interpretation: Pin-Gao Yan, Ruo-Yu Wang, Wei-Ping Zhou

Manuscript writing: Ruo-Yu Wang, Wan Yee Lau, Wei-Ping Zhou

Final approval of manuscript: All authors

Corresponding author

Correspondence to Wei-Ping Zhou.

Ethics declarations

This retrospective study was approved by the ethics committee of the Eastern Hepatobiliary Surgery Hospital (Shanghai, China). Informed consent was obtained from all the patients for their data to be used for research purposes.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Figure S1

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Yan, PG., Wang, RY., Zhang, J. et al. Impact of Preoperative Hepatitis B Virus Levels on Prognosis After Primary and Repeat Hepatectomies for Hepatocellular Carcinoma Patients—a Retrospective Study. J Gastrointest Surg 22, 872–883 (2018). https://doi.org/10.1007/s11605-017-3638-0

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