Effect of radical resection combined with antiviral therapy in patients with hepatitis B virus-associated hepatocellular carcinoma and prognostic analysis.

PURPOSE

To observe the clinical effect of radical resection combined with antiviral therapy in patients with hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC), and to analyze the risk factors affecting its prognosis.

METHODS

The clinical data of 132 patients with HBV-associated HCC treated in our hospital from January 2015 to December 2016 were retrospectively analyzed, and the patients were randomly divided into Control group (n=66) and Anti-virus group (n=66). The changes in liver function indexes, HBV-deoxyribonucleic acid (DNA) load and alpha fetoprotein (AFP) level were compared between the two groups before and after treatment. The tumor recurrence and patients' survival were recorded during the follow-up period, and the possible influencing factors for the prognosis of patients with HBV-associated HCC were analyzed.

RESULTS

After treatment, the levels of alanine aminotransferase (ALT), albumin (ALB), prealbumin (PA) and AFP significantly declined in both groups (p<0.05), while the levels of ALT, PA and AFP were significantly lower in Anti-virus group than those in Control group (p<0.001). After treatment, the HBV-DNA level declined in both groups compared with that before treatment, while it was obviously lower in Anti-virus group than that in Control group (p<0.001). During treatment, the total incidence rate of complications in Anti-virus group was 37.9%, markedly lower than that in Control group 59.1% (p=0.023). The results of log-rank test showed that both OS and PFS rates were far higher in Anti-virus group than those in Control group (p=0.043, p=0.034). The results of Cox multivariate analysis revealed that a low degree of tumor histological differentiation, a large diameter of tumor and no antiviral therapy were independent risk factors affecting the OS rate of patients after treatment (p=0.030, p=0.017).

CONCLUSIONS

Antiviral therapy after radical resection of HBV-associated HCC can effectively inhibit the replication of HBV, reduce the recurrence rate of tumor, and prolong the OS of patients. Low grade of tumor histological differentiation, large diameter of tumor and no antiviral therapy are independent risk factors affecting the OS rate of patients after treatment.