Postoperative anti-HBV improves survival, reduces HCC recurrence after resection
Postoperative anti-hepatitis B virus (HBV) therapy is beneficial for patients with intermediate stage hepatocellular carcinoma (HCC) with high HBV-DNA loads, a new observational study has shown.
Investigators classified 202 HCC patients with high preoperative HBV-DNA levels into those who received postoperative anti-HBV therapy (n=118) and those who did not (n=84). Those who received anti-HBV therapy had significantly higher overall survival (p=0.019) and tumour-free survival (p=0.002) rates compared with those who did not.
The 1-, 3- and 5-year overall survival rates were 91.3, 80.9 and 66.1 percent for those who received anti-HBV therapy and 91.7, 60.7 and 52.4 percent for those who did not, respectively.
The 1-, 3- and 5-year tumour-free survival rates for the anti-HBV therapy group were 87.0, 67.0 and 62.6 percent, respectively. For those who did not receive anti-HBV therapy, the corresponding rates were 82.1, 50.0 and 42.9 percent.
Multivariate analysis showed that no postoperative anti-HBV treatment was significantly correlated with a higher risk of recurrence of HCC after resection (hazard ratio [HR], 0.882; 95 percent CI, 0.712 to 0.938; p=0.042).
Over the follow-up period, 90 cases of HCC recurrence were reported, of which 68 were liver recurrences while 22 were metastases to other organs. The most common site of recurrence was the remnant liver (95.6 percent), while the lungs, abdominal lymph nodes and bone were the common sites of metastasis.
There were 79 death events in the 5-year follow-up. The most common cause was HCC recurrence (n=50) followed by decompensated liver cirrhosis (n=16), a combination of these reasons (n=12) and cardiac failure (n=1).