Department of General Surgery, Qilu Hospital of Shandong University, Jinan, China.
Expert Rev Gastroenterol Hepatol. 2023 Jan-Jun;17(6):623-633. doi: 10.1080/17474124.2023.2212161. Epub 2023 May 9.
Tenofovir (TDF) and entecavir (ETV) are first-line treatments for patients with chronic hepatitis B virus (HBV) infection. However, the effect of TDF versus ETV on the prognosis of HBV-related hepatocellular carcinoma (HCC) has not been fully clarified yet.
PubMed, Embase and Web of science were searched up to March, 2021. Meta-analyses were performed for overall survival (OS), disease-free survival (DFS) and recurrence-free survival (RFS) to assess the effect of TDF versus ETV on the prognosis of HBV-related HCC.
A total of 10 studies comprising 4706 Asian patients were included. The pooled results revealed that TDF was associated with better OS (adjusted HR = 0.50, 95% CI: 0.40-0.62; I = 36.0%, = 0.167) and better RFS/DFS (adjusted HR = 0.70, 95% CI: 0.55-0.89, I = 71.9%, = 0.002) than ETV in treatment of HBV-related HCC. Subgroup analysis revealed that OS benefit from TDF was generally consistent, except for patients who underwent non-surgical treatment for HCC. Subgroup analysis also indicated that TDF reduces the risk of late recurrence (HR = 0.41, 95% CI: 0.18-0.0.93; I = 63.0%, = 0.067) rather than early recurrence (HR = 0.99, 95% CI: 0.64-1.52; I = 61.3%, = 0.076).
Compared with ETV, TDF has the advantage of improving OS and reducing late recurrence of patients with HBV-related HCC patients who underwent resection.
替诺福韦（TDF）和恩替卡韦（ETV）是治疗慢性乙型肝炎病毒（HBV）感染患者的一线药物。然而，TDF 与 ETV 对 HBV 相关肝细胞癌（HCC）预后的影响尚未完全阐明。
检索了 PubMed、Embase 和 Web of science，截至 2021 年 3 月。进行荟萃分析以评估总生存期（OS）、无病生存期（DFS）和无复发生存期（RFS），以评估 TDF 与 ETV 对 HBV 相关 HCC 预后的影响。
共纳入 10 项研究，包括 4706 例亚洲患者。汇总结果显示，TDF 组的 OS（调整 HR=0.50，95%CI：0.40-0.62；I²=36.0%， =0.167）和 RFS/DFS（调整 HR=0.70，95%CI：0.55-0.89，I²=71.9%， =0.002）均优于 ETV。亚组分析显示，TDF 组的 OS 获益普遍一致，除了接受 HCC 非手术治疗的患者。亚组分析还表明，TDF 降低了晚期复发的风险（HR=0.41，95%CI：0.18-0.0.93；I²=63.0%， =0.067），而不是早期复发（HR=0.99，95%CI：0.64-1.52；I²=61.3%， =0.076）。
与 ETV 相比，TDF 具有改善接受切除术的 HBV 相关 HCC 患者 OS 和降低晚期复发的优势。
