12 23

Cited 0 times in

Increasing antiviral treatment uptake improves survival in patients with HBV-related HCC

Authors
 Vicki Wing-Ki Hui  ;  Stephen Lam Chan  ;  Vincent Wai-Sun Wong  ;  Lilian Yan Liang  ;  Terry Cheuk-Fung Yip  ;  Jimmy Che-To Lai  ;  Becky Wing-Yan Yuen  ;  Hester Wing-Sum Luk  ;  Yee-Kit Tse  ;  Hye-Won Lee  ;  Henry Lik-Yuen Chan  ;  Grace Lai-Hung Wong 
Citation
 JHEP REPORTS, Vol.2(6) : 100152, 2020-07 
Journal Title
JHEP REPORTS
Issue Date
2020-07
Keywords
Entecavir ; Hazard ratio ; Lamivudine ; Local ablative therapy ; Propensity scores ; Surgical resection ; Transarterial chemoembolisation
Abstract
Background & Aims: Antiviral treatment is known to improve survival in patients with chronic hepatitis B (CHB)-related hepatocellular carcinoma (HCC). Yet, the treatment uptake in CHB patients remains low. We aimed to report the secular trend in antiviral treatment uptake from 2007-2017, and to compare the effect of different nucleos(t)ide analogue (NA) initiation times (before vs. after HCC diagnosis) on survival. Methods: A 3-month landmark analysis was used to compare overall survival in patients not receiving NA treatment (i.e. no NA), patients receiving NAs after their first HCC treatment (i.e. post-HCC NA), and patients receiving NAs <= 3 months before their first HCC treatment (i.e. pre-HCC NA). A propensity score-weighted Cox proportional hazards model was used to balance clinical characteristics between the 3 groups and to estimate hazard ratios (HRs). Results: The uptake of antiviral treatment in HCC patients increased from 47.3% in 2007 to 98.3% in 2017. The pre-HCC NA group contributed mostly to the uptake rate, which increased from 72.7% to 96.0% in the past decade. In addition, 3,843 CHB patients (407 no NA; 2,932 pre-HCC NA; 504 post-HCC NA) with HCC, receiving at least 1 type of HCC treatment, were included in the analysis. Lack of NA treatment at the time of HCC diagnosis increased the risk of death (weighted HR 3.05; 95% CI 2.70-3.44; p<0.001). The impact of the timing of NA treatment was insignificant (weighted HR 0.90; 95% CI 0.78-1.04; p = 0.161). Conclusions: The uptake of antiviral treatment in HCC patients increased over the past decade. NA treatment, regardless of whether it was initiated before or after HCC diagnosis, improved survival. It is never too late to initiate NA treatment, even after HCC diagnosis. (C) 2020 The Author(s). Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL).
Files in This Item:
T9992020111.pdf Download
DOI
10.1016/j.jhepr.2020.100152
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Hye Won(이혜원) ORCID logo https://orcid.org/0000-0002-3552-3560
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/189894
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse

Links