Tertiary Prevention of HBV-related HCC in Asia
Chronic hepatitis B is the leading cause of hepatocellular carcinoma (HCC) in Asia. Despite liver resection or local ablation therapy, up to 70 % of patients will have HCC recurrence. While early HCC recurrence within 2 years of index treatment is mainly associated with tumor characteristics such as vascular invasion and tumor number, late recurrence arises due to field effect and is associated with high hepatitis B virus DNA level and hepatic necroinflammation. Although current data suggest that antiviral therapy can reduce the risk of cirrhosis and incident HCC, its role in preventing HCC recurrence after curative treatment remains controversial. In recent years, knowledge on the signaling pathways of HCC has led to exciting development in targeted therapy, with sorafenib being the first to be registered for the treatment of advanced HCC. Further studies are needed to clarify the role of targeted therapy in the adjuvant setting to prevent HCC recurrence.
KeywordsHepatitis B HBV DNA Hepatocellular carcinoma Cirrhosis Lamivudine Entecavir Tenofovir Interferon Sorafenib Sirolimus
hepatitis B e antigen
hepatitis B surface antigen
hepatitis B virus
mammalian target of rapamycin
orthotopic liver transplantation