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Antiviral Therapy Decreases Recurrence of Hepatitis B Virus-related Hepatocellular Carcinoma after Curative Resection: A Meta-analysis

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Abstract

Background

The long-term outcome after curative resection of hepatocellular carcinoma (HCC) remains unsatisfactory because of the high incidence of recurrence. The present study was intended to assess the impact of hepatitis B virus (HBV) DNA level and nucleos(t)ide analog therapy on posthepatectomy recurrence of HBV-related HCC.

Methods

Eligible studies were identified through a computerized literature search. The pooled relative risk ratio (RR) with 95 % confidence interval (CI) was calculated using Review Manager 5.1 Software.

Results

Twenty studies with a total of 8,204 participants were included for this meta-analysis. Pooled analysis showed that high viral load was significantly associated with risk of recurrence (RR: 1.85, 95 % CI: 1.41–2.42; P < 0.001), poorer disease-free survival (DFS) (RR: 1.96, 95 % CI: 1.62–2.38; P < 0.001), and poorer overall survival (OS) (RR: 1.47, 95 % CI: 1.22–1.77; P < 0.001) of HBV-related HCC after surgical resection. Nucleos(t)ide analog therapy significantly decreased the recurrence risk (RR: 0.69, 95 % CI: 0.59–0.80; P < 0.001) and improved both DFS (RR: 0.70, 95 % CI: 0.58–0.83; P < 0.001) and OS (RR: 0.46, 95 % CI: 0.32–0.68; P < 0.001).

Conclusions

High DNA level is associated with posthepatectomy recurrence of HBV-related HCC. Nucleos(t)ide analog therapy improves the prognosis of HBV-related HCC after resection.

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Authors and Affiliations

  1. Department of Hepatobiliary & Pancreatovascular Surgery, Oncologic Center of Xiamen, First Affiliated Hospital of Xiamen University, 55 Zhenhai Road, Xiamen, 361003, China

    Yanming Zhou, Lupeng Wu & Bin Li

  2. Testing Center for Occupational Health, Shanghai Institute of Occupational Safety and Health, Shanghai, China

    Zhansai Zhang

  3. Department of Health Statistics, Second Military Medical University, Shanghai, China

    Yanfang Zhao

Authors
  1. Yanming Zhou
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  2. Zhansai Zhang
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  3. Yanfang Zhao
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  4. Lupeng Wu
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  5. Bin Li
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Corresponding author

Correspondence to Yanming Zhou.

Additional information

Yanming Zhou and Zhansai Zhang contributed equally to this work.

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Zhou, Y., Zhang, Z., Zhao, Y. et al. Antiviral Therapy Decreases Recurrence of Hepatitis B Virus-related Hepatocellular Carcinoma after Curative Resection: A Meta-analysis. World J Surg 38, 2395–2402 (2014). https://doi.org/10.1007/s00268-014-2586-z

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