Hu Lingbo, Yang Chao, Qiao Yingli, Wang Aidong
Department of Hepatopancreatobiliary Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China.
Department of Hepatopancreatobiliary Surgery, Enze Hospital, Taizhou Enze Medical Center (Group), Taizhou, Zhejiang, China.
Front Pharmacol. 2024 Jul 29;15:1443551. doi: 10.3389/fphar.2024.1443551. eCollection 2024.
Tenofovir (TDF) and entecavir (ETV) are highly effective and well-tolerated nucleos(t)ide analogs commonly prescribed for hepatitis B virus (HBV) treatment. Yet, it is unclear whether survival outcomes differ for HBV-related hepatocellular carcinoma (HCC) patients treated with ETV and TDF. Thus, this meta-analysis aimed to compare the prognostic effectiveness of ETV and TDF in HBV-related HCC patients.
We comprehensively searched four databases, PubMed, Web of Science, Embase, and the Cochrane Library, to identify pertinent studies utilizing keywords "entecavir," "tenofovir," "hepatocellular carcinoma," and "liver resection." Our primary outcomes of interest encompassed overall survival (OS), recurrence-free survival (RFS), early recurrence, and late recurrence. The statistical effect size for these measures was expressed in terms of hazard ratios (HRs).
Our search yielded 10 studies encompassing 11 datasets involving 7,400 patients. Our meta-analysis revealed that patients treated with TDF achieved better OS (HR = 0.53; 95% confidence interval [CI] = 0.40-0.70, < 0.0001), RFS (HR = 0.68; 95% CI = 0.57-0.80; < 0.0001), early recurrence (HR = 0.80; 95% CI = 0.67-0.94; < 0.0077), and late recurrence (HR = 0.64; 95% CI = 0.43-0.97; = 0.0368). We detected publication bias potentially affecting OS but not RFS.
Our findings demonstrated that TDF outperformed ETV regarding RFS for HBV-related HCC patients. However, to bolster the evidence and establish more conclusive conclusions, further validation via extensive and high-quality randomized controlled trials is essential.
https://www.crd.york.ac.uk/prospero/#recordDetails, identifier CRD 42024542579.
替诺福韦（TDF）和恩替卡韦（ETV）是常用于治疗乙型肝炎病毒（HBV）的高效且耐受性良好的核苷（酸）类似物。然而，接受ETV和TDF治疗的HBV相关肝细胞癌（HCC）患者的生存结果是否存在差异尚不清楚。因此，本荟萃分析旨在比较ETV和TDF对HBV相关HCC患者的预后效果。
我们全面检索了四个数据库，即PubMed、科学网、Embase和Cochrane图书馆，以使用关键词“恩替卡韦”、“替诺福韦”、“肝细胞癌”和“肝切除术”来识别相关研究。我们感兴趣的主要结局包括总生存期（OS）、无复发生存期（RFS）、早期复发和晚期复发。这些指标的统计效应大小用风险比（HRs）表示。
我们的检索产生了10项研究，涵盖11个数据集，涉及7400名患者。我们的荟萃分析显示，接受TDF治疗的患者在OS（HR = 0.53；95%置信区间[CI] = 0.40 - 0.70，< 0.0001）、RFS（HR = 0.68；95% CI = 0.57 - 0.80；< 0.0001）、早期复发（HR = 0.80；95% CI = 0.67 - 0.94；< 0.0077）和晚期复发（HR = 0.64；95% CI = 0.43 - 0.97；= 0.0368）方面表现更好。我们检测到可能影响OS但不影响RFS的发表偏倚。
我们的研究结果表明，对于HBV相关HCC患者，在RFS方面TDF优于ETV。然而，为了加强证据并得出更确凿的结论，通过广泛且高质量的随机对照试验进行进一步验证至关重要。
https://www.crd.york.ac.uk/prospero/#recordDetails，标识符CRD 42024542579。
