Elevated lactate impairs the efficacy of antiviral treatment on post-hepatectomy survival for advanced stage hepatitis B virus?–?related hepatocellular carcinoma - 07/02/19
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Highlights |
• | NAs have a risk of mitochondrial toxicity and then inducing the increase of lactate. |
• | NAs improve the long-term outcomes of HBV-related HCC after curative liver resection. |
• | NAs could not improve the prognosis of advanced stage HBV-related HCC for elevated lactate. |
• | The progression of HCC and NAs could induce the increase of lactate in advanced HCCs. |
• | Elevated lactate predicts bad prognosis for HBV-related HCC after curative liver resection. |
Summary |
Background |
Nucleoside and nucleotide analogues (NAs) have a risk of mitochondrial toxicity and then inducing the increase of lactate. We aim to evaluate the impact of lactate on the effects of NAs therapy in hepatitis B virus-related hepatocellular carcinoma (HCC) patients after curative liver resection.
Materials and methods |
Five hundred and fifty-seven HBV-related HCC patients were divided into the treatment and control group according to whether they received NAs therapy or not. Perioperative and prognosis data were retrospectively reviewed.
Results |
The treatment group had a better overall survival rate (OS) than the control group (P = 0.017). The recurrence-free survival rate (RFS) did not significantly differ between the two groups (P = 0.174). NAs could improve the OS of early stage HCC patients (P = 0.028), as well as the OS of advanced stage HCC patients with low level of lactate in subgroup analysis stratified against the level of lactate (P = 0.037). Advanced stage HCC patients in the treatment group had a higher value of lactate than those in the control group (P = 0.024). Besides, advanced stage HCC patients had a higher value of lactate than early stage HCC patients in the treatment group (P < 0.001), as well as in the control group (P < 0.001).
Conclusions |
NAs could improve the long-term outcomes of HBV-related HCC patients after curative liver resection. However, the improvement effect of NAs therapy is counteracted by the adverse effect of elevated lactate in advanced stage HBV-related HCC patients.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Hepatitis B virus, Hepatocellular carcinoma, Nucleotide and nucleotide analogues, Lactate
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Vol 43 - N° 1
P. 67-76 - Febbraio 2019 Ritorno al numero
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