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The influence of hepatitis B DNA level and antiviral therapy on recurrence after initial curative treatment in patients with hepatocellular carcinoma

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

Prediction and prevention of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) recurrence is an important clinical issue. We investigated whether HBV DNA level and antiviral therapy are associated with HCC recurrence.

Methods

This retrospective study involved 103 patients who underwent hepatic resection or radiofrequency ablation for initial HCC. Patients were divided into four groups. Thirty had high serum HBV DNA levels (>4 log10 copies/mL) and had not received antiviral therapy (high virus group; HVG). Thirty-four had low HBV DNA levels (≤4 log10 copies/mL) and had not received antiviral therapy (low virus group; LVG). Twenty received antiviral therapy after HCC developed (therapeutic group A, TG-A). Nineteen received antiviral therapy before HCC developed (therapeutic group B, TG-B).

Results

Cumulative HCC recurrence rates at 3 years in the HVG, LVG, TG-B, and TG-A were 71.1%, 42.2%, 42.3%, and 52.0%, respectively. Recurrence rates differed significantly between the HVG and LVG (P = 0.016) and between the HVG and TG-B (P = 0.008). Recurrence rate in the TG-A was marginally lower than in the HVG (P = 0.10). On multivariate analysis, high serum hepatitis B virus DNA levels (hazard ratio: HR 2.67; 95% CI 1.31–5.47; P = 0.007) and absence of antiviral therapy (HR 2.57; 95% CI 1.34–4.94; P = 0.005) were independent risk factors for hepatocellular carcinoma recurrence.

Conclusion

HBV DNA level and antiviral therapy are associated with HCC recurrence. For patients with high HBV DNA levels, antiviral therapy before the development of HCC is important for prevention of recurrence.

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Authors and Affiliations

  1. Department of Gastroenterology and Hematology, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan

    Makoto Chuma, Shuhei Hige, Mitsuru Nakanishi, Toshihisa Kohara, Takuya Sho, Keiko Yamamoto, Hiromasa Horimoto, Tomoe Kobayashi & Masahiro Asaka

  2. Department of General Surgery, Hokkaido University, Sapporo, Japan

    Toshiya Kamiyama, Kazuaki Nakanishi, Hideki Yokoo, Michiaki Matsushita & Satoru Todo

  3. Department of Internal Medicine, Hokkaido Gastroenterology Hospital, Sapporo, Japan

    Takashi Meguro

  4. Department of Gastroenterology, Sapporo Municipal Hospital, Sapporo, Japan

    Atsushi Nagasaka

  5. Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan

    Yoshiya Yamamoto

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  1. Makoto Chuma
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Correspondence to Makoto Chuma.

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Chuma, M., Hige, S., Kamiyama, T. et al. The influence of hepatitis B DNA level and antiviral therapy on recurrence after initial curative treatment in patients with hepatocellular carcinoma. J Gastroenterol 44, 991–999 (2009). https://doi.org/10.1007/s00535-009-0093-z

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  • DOI: https://doi.org/10.1007/s00535-009-0093-z

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