Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea.
PLoS One. 2024 Aug 26;19(8):e0307712. doi: 10.1371/journal.pone.0307712. eCollection 2024.
Antiviral therapy (AVT) is required in patients with newly diagnosed hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC), if HBV DNA is detectable. We compared the risk of recurrence according to HBV replication activity at the curative treatment of HBV-related HCC.
Patients with HBV-related HCC who underwent surgical resection or radiofrequency ablation between 2013 and 2018 were enrolled in this retrospective cohort study. Patients were categorized into two groups according to HBV replication activity at the curative treatment of HBV-related HCC (group 1: patients who met the AVT indication for HBV-related HCC due to detectable HBV DNA but did not meet the AVT indication if without HCC; group 2: patients who met the AVT indication, regardless of HCC).
In the entire cohort (n = 911), HCC recurred in 303 (33.3%) patients during a median follow-up of 4.7 years. After multivariate adjustment, group 2 showed a statistically similar risk of HCC recurrence (adjusted hazard ratio [aHR] = 1.18, P = 0.332) compared to that of group 1. In addition, group 2 showed statistically similar risks of early (< 2 years; aHR = 1.31) and late (≥ 2 years; aHR = 0.83) recurrence than that of group 1 (all P>0.05). Propensity score matching and inverse probability of treatment weighting analysis also yielded similar risks of HCC recurrence between the two groups (all P>0.05, log-rank tests).
The risk of HCC recurrence in patients who received curative treatment for newly diagnosed HBV-related HCC was similar regardless of HBV replication activity, if AVT was properly initiated.
对于新诊断的乙型肝炎病毒(HBV)相关肝细胞癌(HCC)患者,如果可检测到 HBV DNA,则需要抗病毒治疗(AVT)。我们比较了在根治性治疗 HBV 相关 HCC 时根据 HBV 复制活性的复发风险。
本回顾性队列研究纳入了 2013 年至 2018 年间接受手术切除或射频消融治疗的 HBV 相关 HCC 患者。根据根治性治疗 HBV 相关 HCC 时的 HBV 复制活性,将患者分为两组(组 1:由于可检测到 HBV DNA 而符合 HCC 抗病毒治疗指征但不符合无 HCC 抗病毒治疗指征的患者;组 2:符合抗病毒治疗指征的患者,无论是否存在 HCC)。
在整个队列(n=911)中,中位随访 4.7 年后,303(33.3%)例患者 HCC 复发。经多变量调整后,组 2 的 HCC 复发风险与组 1 相比具有统计学上的相似性(调整后的危险比[aHR]=1.18,P=0.332)。此外,与组 1 相比,组 2 具有统计学相似的早期(<2 年;aHR=1.31)和晚期(≥2 年;aHR=0.83)复发风险(所有 P>0.05)。倾向评分匹配和逆概率治疗加权分析也得出两组间 HCC 复发风险相似(所有 P>0.05,对数秩检验)。
对于接受新诊断的 HBV 相关 HCC 根治性治疗的患者,如果适当开始 AVT,则 HBV 复制活性对 HCC 复发风险无影响。