HBV infection a favourable prognostic marker in operable oesophageal cancer
Survival in oesophageal cancer patients undergoing oesophagectomy appears to be better in the presence of hepatitis B virus (HBV) infection, a study has found.
The study included 2,004 consecutive patients who underwent surgery for their oesophageal cancer. Serum HBV markers were tested using ELISA, and results showed that 253 patients (12.6 percent) were positive for HBV infection (HBsAg-positive).
Compared with those who were not infected, patients who were HBsAg-positive were more likely to have early pathological T stage (39.5 percent vs 26.3 percent; p=0.002) and never consumed alcohol (74.3 percent vs 68.5 percent; p=0.033). The HBsAg-positive group also had a lower frequency of liver metastasis (0.8 percent vs 3.1 percent; p=0.036) and extrahepatic metastasis (3.2 percent vs 6.7 percent; p=0.028).
HBsAg positivity was associated with about a 20-percent increase in disease-free survival (DFS; hazard ratio [HR], 0.79, 95 percent CI, 0.66–0.94; p=0.007) and overall survival (OS; HR, 0.80, 0.65–0.95; p=0.020) when compared with HBsAg negativity.
Subgroup analysis showed that the survival gains associated with HBV infection were greater among patients with oesophageal squamous cell carcinoma (ESCC) and advanced pathologic stage (III–IV).
The present data suggest that HBV infection might serve as a useful biomarker to predict survival in patients with oesophageal cancer, especially advanced pathological stage ESCC patients, researchers said, adding that the infection activates the liver-associated immunity to decrease the incidence of liver metastasis in cancer patients.
Additional prospective studies are warranted to determine the prognostic and treatment value of HBV infection in oesophageal cancer, the researchers added.