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Persistent hepatitis B viral replication affects recurrence of hepatocellular carcinoma after curative resection

Authors
 Beom Kyung Kim  ;  Jun Yong Park  ;  Do Young Kim  ;  Ja Kyung Kim  ;  Kyung Sik Kim  ;  Jin Sub Choi  ;  Byung Soo Moon  ;  Kwang Hyub Han  ;  Chae Yoon Chon  ;  Young Myoung Moon  ;  Sang Hoon Ahn 
Citation
 LIVER INTERNATIONAL, Vol.28(3) : 393-401, 2008 
Journal Title
 LIVER INTERNATIONAL 
ISSN
 1478-3223 
Issue Date
2008
MeSH
Adult ; Aged ; Carcinoma, Hepatocellular/etiology ; Carcinoma, Hepatocellular/surgery* ; Carcinoma, Hepatocellular/virology* ; DNA, Viral/blood ; Female ; Hepatitis B virus/genetics* ; Humans ; Liver/diagnostic imaging ; Male ; Middle Aged ; Neoplasm Recurrence, Local/virology* ; Tomography, X-Ray Computed ; Viremia/complications ; Viremia/physiopathology* ; Virus Replication/genetics*
Keywords
hepatitis B virus ; hepatocellular carcinoma ; recurrence ; replication ; viraemia
Abstract
BACKGROUND: Elevated serum hepatitis B virus (HBV) DNA increases the development of hepatocellular carcinoma (HCC). Rather than instantaneous DNA level, the duration of persistent HBV replication is more important in carcinogenesis. Nevertheless, most investigators evaluated the DNA level at study entry. We assessed the effects of persistently detectable serum HBV DNA on HCC recurrence. PATIENTS AND METHODS: We included 230 consecutive patients undergoing curative resection between 2000 and 2006. Patients who had antiviral therapy (at diagnosis or during follow-up), fluctuating DNA (cut-off value: 100,000 copies/ml) or recurrence within 12 months of resection were excluded. Ultimately, 157 were enrolled: 89 (non-viraemia group) had consistently negative DNA (<100,000 copies/ml), while 68 (viraemia group) had consistently positive DNA (>100 000copies/ml). Serum DNA level, biochemical tests, alpha-foetoprotein (AFP) and liver dynamic computed tomography were obtained every 3 months after surgery. RESULTS: There were no significant differences in age, gender, liver function, histology, AFP, tumour stages or follow-up duration between the two groups. During follow-up (median: 35 months), patients in the non-viraemia group had a lower 5-year cumulative recurrence rate (54.7%) than those in the viraemia group (72.9%; P=0.043). In multivariate analysis, sustained viraemia (P=0.041) increased recurrence independently. CONCLUSIONS: Persistent viraemia increased recurrence independently after surgery. To prevent long-term recurrences, antiviral therapy should be initiated in those with detectable serum HBV DNA
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2007.01625.x/abstract
DOI
10.1111/j.1478-3231.2007.01625.x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Kim, Do Young(김도영)
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Ja Kyung(김자경) ORCID logo https://orcid.org/0000-0001-5025-6846
Moon, Byung Soo(문병수)
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Chon, Chae Yoon(전재윤)
Choi, Jin Sub(최진섭)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/106796
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