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Post-operative recurrence of liver cancer according to antiviral therapy for detectable hepatitis B viremia: A nationwide study

Authors
 Byungyoon Yun  ;  Sang Hoon Ahn  ;  Juyeon Oh  ;  Jin-Ha Yoon  ;  Beom Kyung Kim 
Citation
 EUROPEAN JOURNAL OF INTERNAL MEDICINE, Vol.107 : 66-72, 2023-01 
Journal Title
EUROPEAN JOURNAL OF INTERNAL MEDICINE
ISSN
 0953-6205 
Issue Date
2023-01
MeSH
Antiviral Agents / therapeutic use ; Carcinoma, Hepatocellular* / surgery ; DNA, Viral ; Hepatitis B virus ; Hepatitis B* / complications ; Hepatitis B* / drug therapy ; Hepatitis B, Chronic* / complications ; Hepatitis B, Chronic* / drug therapy ; Humans ; Liver Cirrhosis ; Liver Neoplasms* / surgery ; Retrospective Studies ; Viremia / drug therapy
Keywords
Antiviral therapy ; Hepatitis B virus ; Hepatocellular carcinoma ; Liver cirrhosis
Abstract
Background: High postoperative recurrence of hepatitis B virus (HBV)-infected hepatocellular carcinoma (HCC) remains a significant challenge. Here, we aimed to compare the postoperative HCC recurrence between patients with AVT for detectable serum HBV-DNA vs. those without.

Methods: Data of patients undergoing curative resection of HBV-infected HCC as an initial therapy from 2015 to 2017 were obtained from the National Health Insurance Service database in South Korea. AVT was initiated when serum HBV-DNA was detectable. The primary outcome was HCC recurrence. The cumulative risk of HCC recurrence between AVT users and non-users was estimated using the Kaplan-Meier method.

Results: During follow-up (median 2.7 years) with 3034 patients, 25.7% and 23.6% of AVT users and non-users experienced HCC recurrence, respectively. The 1-, 2-, and 3-year cumulative recurrence rates were similar (p = 0.57): 15.6%, 23.3%, and 26.4% in AVT users versus 15.3%, 22.0%, and 24.9% in non-users, respectively. After adjusting for covariates, multivariable Cox regression analysis showed comparable outcomes between the two groups with adjusted hazard ratios (aHR 1.08, 95% confidence interval [CI] 0.89-1.31; p = 0.439). Similar outcomes between the two groups were reproduced after stratification of liver cirrhosis. Inverse probability treatment weighting analysis also showed comparable outcomes between the two groups in the subgroups with liver cirrhosis (aHR 1.01, 95% CI 0.80-1.29; p = 0.92) and non-cirrhosis (aHR 1.08, 95% CI 0.87-1.34; p = 0.472).

Conclusions: Initiating AVT based on detectable serum HBV-DNA provided the similar risk of postoperative HCC recurrence in HBV-infected HCC patients with and without detectable serum HBV-DNA.
Full Text
https://www.sciencedirect.com/science/article/pii/S0953620522003880
DOI
10.1016/j.ejim.2022.10.026
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Yun, Byungyoon(윤병윤)
Yoon, Jin Ha(윤진하) ORCID logo https://orcid.org/0000-0003-4198-2955
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/193724
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