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Effects of antiviral therapy on long-term outcome after liver resection for hepatitis B virus-related hepatocellular carcinoma

  • Original article
  • Published:
Journal of Hepato-Biliary-Pancreatic Sciences

An Erratum to this article was published on 14 April 2012

Abstract

Background/purpose

We investigated the effects of nucleos(t)ide analogues (NAs) on long-term outcome in patients following curative treatment for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).

Methods

This study involved 70 of the 76 patients who had undergone liver resection for HBV-related HCC in our department; 6 patients were excluded due to non-curative resection or advanced cancer. The 70 patients were divided into three groups, as follows: 13 patients with high serum concentration of HBV DNA (≥4 log10 copies/mL) and no antiviral therapy (high viral group); 46 patients who received antiviral therapy during the serial follow up (antiviral therapy group) because of high viral concentration (≥4 log10 copies/mL); and 11 patients with low serum concentration of HBV DNA (<4 log10 copies/mL) and no antiviral therapy (low viral group).

Results

Tumor-free survival rate was significantly higher in the low viral group than in the high viral group (P = 0.0058). Multivariate analysis revealed that a high serum concentration of HBV DNA (≥4 log10 copies/mL) (risk ratio 6.717, 95% confidence interval 1.435–31.434, P = 0.0156) was an independent risk factor for a short tumor-free survival time. Tumor-free survival rate was significantly higher in the antiviral therapy group than in the high viral group (P = 0.0478). Multivariate analysis revealed that presence of multiple tumors (risk ratio 2.857, 95% confidence interval 1.403–5.816, P = 0.0038) was an independent risk factor for a short tumor-free survival time. The cumulative survival rate was significantly higher in the antiviral therapy group than in the high viral group (P = 0.0025). Multivariate analysis revealed that not undergoing antiviral therapy (risk ratio 0.121, 95% confidence interval 0.024–0.608, P = 0.0104) was an independent risk factor for a short survival time.

Conclusions

A high serum concentration of HBV DNA (≥4 log10 copies/mL) was a strong risk factor for HCC recurrence after resection of HBV-related HCC. Antiviral therapy with NAs improved the long-term outcome after resection of HBV-related HCC in patients with high serum concentrations of HBV DNA.

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Abbreviations

HBV:

Hepatitis B virus

HCC:

Hepatocellular carcinoma

NAs:

Nucleos(t)ide analogues

LAM:

Lamivudine

ADV:

Adefovir dipivoxil

ETV:

Entecavir

HAI:

Histological activity index

TACE:

Transcatheter arterial chemoembolization

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Authors and Affiliations

  1. Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan

    Yorihisa Urata, Shoji Kubo, Shigekazu Takemura, Takahiro Uenishi, Shintaro Kodai, Hiroji Shinkawa, Masayuki Sakae, Kazuhisa Kaneda, Kazunori Ohata & Akinori Nozawa

  2. Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan

    Shigefumi Suehiro

Authors
  1. Yorihisa Urata
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  2. Shoji Kubo
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  3. Shigekazu Takemura
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  11. Shigefumi Suehiro
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Correspondence to Yorihisa Urata.

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Urata, Y., Kubo, S., Takemura, S. et al. Effects of antiviral therapy on long-term outcome after liver resection for hepatitis B virus-related hepatocellular carcinoma. J Hepatobiliary Pancreat Sci 19, 685–696 (2012). https://doi.org/10.1007/s00534-011-0489-z

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