Effect of oral antiviral treatment on long-term outcomes of radiofrequency ablation therapy for hepatitis B virus-related hepatocellular carcinoma
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Won Sohn1,2,*, Tae Wook Kang3,*, Sun-Kyu Choi4, Sin-Ho Jung4, Min Woo Lee3, Hyo Keun Lim3,5, Ju-Yeon Cho1,6, Sang Goon Shim7, Dong Hyun Sinn1, Geum-Youn Gwak1, Moon Seok Choi1, Joon Hyeok Lee1, Kwang Cheol Koh1, Seung Woon Paik1, Hyunchul Rhim3,#, Yong-Han Paik1,5,#
1Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
2Department of Hepatology, Bundang Jesaeng Hospital, Sungnam, Korea
3Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
4Department of Biostatistics and Clinical Epidemiology, Samsung Medical Center, Seoul, Korea
5Department of Health Science and Technology, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Korea
6Department of Medicine, Chosun University Hospital, Gwang-Ju, Korea
7Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
*These authors have contributed equally to this work
#These authors share senior authorship
Yong-Han Paik, email: [email protected]
Keywords: hepatocellular carcinoma, radiofrequency ablation, chronic hepatitis B, antiviral treatment
Received: January 08, 2016 Accepted: May 28, 2016 Published: June 14, 2016
Objectives: This study aimed to investigate the effect of oral antiviral treatment on the prognosis of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after radiofrequency (RF) ablation.
Methods: Between January 2003 and December 2010, 228 patients without a history of antiviral treatment were treated with RF ablation for a single HBV-related HCC. We divided the patients into two groups, patients who received (n=125) or did not receive antiviral treatment (n=103), based on whether oral antiviral treatment was administered after RF ablation. The median duration of antiviral treatment was 60.1 months. HCC recurrence and overall survival were compared in the two groups in the full cohort and the propensity score-matched cohort.
Results: In the matched cohort, the probability of HCC recurrence at 5 years was 43.8% for the non-antiviral treatment group and 14.7% for the antiviral treatment group (p<0.001). The probability of overall survival at 5 years was 77.2% for the non-antiviral treatment group and 93.5% for the antiviral treatment group (p=0.002). Multivariable analysis showed that risk factors for HCC recurrence included large tumor size (hazard ratio (HR)=1.30, p=0.022), HBV DNA serum level (HR=1.11, p=0.005), and serum AFP level ≥20 ng/mL (HR=1.66, p=0.005). Overall survival was associated with larger tumor size (HR=1.86, p=0.001) and Child-Pugh Class B (HR=2.13, p=0.019). Oral antiviral treatment after RF ablation was significantly associated with a lower risk of tumor recurrence and death (HR=0.33, p<0.001, and HR=0.44, p=0.004).
Conclusion: Use of oral antiviral treatment after curative RF ablation was associated with favorable outcomes in terms of tumor recurrence and overall survival in patients with HBV-related HCC.
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