Antiviral therapy improves postoperative survival of patients with HBV-related hepatocellular carcinoma - 20/06/22

Doi : 10.1016/j.amjsurg.2022.01.008

Ruo-Yu Guan ^{^{1
These authors contributed equally to this work.}}, Bao-Ye Sun ^{^{1
These authors contributed equally to this work.}}, Zhu-Tao Wang ^{^{1
These authors contributed equally to this work.}}, Cheng Zhou, Zhang-Fu Yang, Wei Gan, Jin-Long Huang, Gao Liu, Jian Zhou, Jia Fan, Yong Yi ^⁎ , Shuang-Jian Qiu ^⁎
Department of Liver Surgery and Transplantation, Zhongshan Hospital, Fudan University, Liver Cancer Institute, Fudan University, Key Laboratory for Carcinogenesis & Cancer Invasion, The Chinese Ministry of Education, Shanghai, China

^∗Corresponding author. Department of Liver Surgery and Transplantation, Zhongshan Hospital, Fudan University, Liver Cancer Institute, Fudan University, Key Laboratory for Carcinogenesis & Cancer Invasion, The Chinese Ministry of Education, No 180, Fenglin Road, Shanghai, 200032, China.Department of Liver Surgery and TransplantationZhongshan HospitalFudan UniversityLiver Cancer InstituteFudan UniversityKey Laboratory for Carcinogenesis & Cancer InvasionThe Chinese Ministry of EducationNo 180, Fenglin RoadShanghai200032China^∗∗Corresponding author. Department of Liver Surgery and Transplantation, Zhongshan Hospital, Fudan University, Liver Cancer Institute, Fudan University, Key Laboratory for Carcinogenesis & Cancer Invasion, The Chinese Ministry of Education, No 180, Fenglin Road, Shanghai, 200032, , China.Department of Liver Surgery and TransplantationZhongshan HospitalFudan UniversityLiver Cancer InstituteFudan UniversityKey Laboratory for Carcinogenesis & Cancer InvasionThe Chinese Ministry of EducationNo 180, Fenglin RoadShanghai200032China

Abstract

Background

We aimed to investigate whether improvements in the prognosis of patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) who have undergone hepatectomy are associated with reductions in the liver inflammation and fibrosis by antiviral therapy (AVT).

Methods

Patients who underwent hepatectomy and re-hepatectomy for HBV-related HCC between 2010 and 2019 were divided into two groups. Histological changes in liver were compared between initial and recurrence stages within each group. Propensity score matching (PSM) analysis was performed to compare prognostic outcomes.

Results

After PSM, AVT group showed a significantly better prognosis than did non-AVT group (RFS: 19.1% vs. 5.8%, P = 0.001; OS: 64.0% vs. 43.2%, P < 0.001). The improvements in G and S were independent protective factors for RFS (G: P < 0.001; S: P < 0.001) and OS (G: P = 0.013; S: P < 0.001).

Conclusions

The application of AVT after initial surgery improved liver inflammation and fibrosis, further benefiting long-term outcomes of patients with HBV-related HCC.

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Highlights

•	Antiviral therapy (AVT) is associated better postoperative outcomes in patients with HBV-related HCC.
•	Long-term AVT could lead to the improvement of liver inflammation and fibrosis.
•	The improvement in liver inflammation and fibrosis resulting from AVT is associated with a better postoperative prognosis.

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Keywords : Hepatocellular carcinoma, Hepatitis B virus, Antiviral therapy, Liver inflammation, Survival

Plan

Introduction

Materials and methods

Study population

Evaluation methods for the G and S

Follow-up protocol and definition

Statistical methods

Results

Clinicopathological characteristics of the patients before and after PSM

AVT was associated with better RFS and OS either before or after PSM

The improvements in the G and S in non-cancerous liver tissues were significantly associated with AVT in the entire cohort

Independent risk factors of RFS and OS in the PSM cohort

The improvement in liver inflammation occurred prior to that in fibrosis after AVT initiation

Subgroup analysis of the effect of the initiation and duration of AVT on the postoperative outcomes

Discussion

Funding

Export

Vol 224 - N° 1PB

P. 494-500 - juillet 2022 Retour au numéro

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Antiviral therapy improves postoperative survival of patients with HBV-related hepatocellular carcinoma - 20/06/22

Abstract

Background

Methods

Results

Conclusions

Highlights

Plan

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