Abstract | BACKGROUND AND AIMS: Although antiviral treatment has been shown to reduce mortality in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) patients with high HBV- DNA levels, it is still unclear whether it is useful in reducing mortality in patients with low HBV- DNA levels. METHODS: A retrospective analysis of 756 HBV-associated HCC patients at the Beijing Ditan Hospital with HBV- DNA levels < 500 IU/mL was conducted between January 2008 and June 2017. Patients were divided into antiviral and non- antiviral groups based on whether they received nucleos(t)ide analogue (NA) treatment when they were diagnosed with HCC in our hospital for the first time. We used 1:4 frequency matching by age, gender, tumor size, Barcelona Clinic Liver Cancer (BCLC) staging, anti- tumor therapy, cirrhosis, diabetes, and hyperlipoidemia to compare the antiviral (n = 366) and non- antiviral (n = 100) groups. A Cox multivariate regression analysis was employed to evaluate the effects of NA therapy on the hazard ratio (HR), and the Kaplan-Meier survival curve was used to determine the mortality risk in patients with HCC. A Log rank test was performed to analyze the effects of NA therapy on the survival rate of patients with HCC. RESULTS: After propensity score matching, the 1-, 3-, and 5-year overall survival (OS) rates for the antiviral and non- antiviral groups were 82.5%, 68.6%, and 52.2%, and 61.0%, 51.0%, and 38.0%, respectively. The l-year progression-free survival (PFS) rates for the two groups were 68.0% and 47.0%, respectively. The OS of the antiviral group was significantly higher than that of the control group (P < 0.001, P = 0.001, and P = 0.013, respectively). The 1-year PFS for the antiviral group was also significantly better than that for the non- antiviral groups (P = 0.005). After adjusting for confounding prognostic factors in the Cox model, the HR of 5-year death after antiviral treatment was 0.721 (95% confidence interval [CI], 0.530-0.980, P = 0.037). Antiviral therapy is an independent protective factor for 5-year mortality in patients with HCC and low-level viremia. CONCLUSION:
|
Authors | Xinhui Wang, Xiaoli Liu, Peng Wang, Lihua Yu, Fengna Yan, Huiwen Yan, Dongdong Zhou, Zhiyun Yang |
Journal | Journal of hepatocellular carcinoma
(J Hepatocell Carcinoma)
Vol. 8
Pg. 1253-1267
( 2021)
ISSN: 2253-5969 [Print] New Zealand |
PMID | 34708007
(Publication Type: Journal Article)
|
Copyright | © 2021 Wang et al. |