A Comparative Study of Antiviral Therapy After Resection of Hepatocellular Carcinoma in the Immune-Active Phase of Hepatitis B Virus Infection

被引:144
作者
Li, Nan [1 ]
Lai, Eric C. H. [2 ]
Shi, Jie [1 ]
Guo, Wei-Xing [1 ]
Xue, Jie [1 ]
Huang, Bing [1 ]
Lau, Wan-Yee [1 ,2 ]
Wu, Meng-Chao [1 ]
Cheng, Shu-Qun [1 ]
机构
[1] Second Mil Med Univ, Eastern Hepatobiliary Surg Hosp, Shanghai, Peoples R China
[2] Chinese Univ Hong Kong, Fac Med, Hong Kong, Hong Kong, Peoples R China
关键词
RANDOMIZED CLINICAL-TRIAL; INTERFERON THERAPY; INITIAL TREATMENT; LAMIVUDINE; MANAGEMENT; RECURRENCE; ABLATION; CANCER;
D O I
10.1245/s10434-009-0694-z
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The role of antiviral therapy for patients in the immune-active phase of hepatitis B virus (HBV) infection who underwent partial hepatectomy for hepatocellular carcinoma (HCC) is unknown. From January 2004 to June 2007, a nonrandomized comparative study for postoperative antiviral treatment was conducted on patients who underwent curative hepatectomy for advanced HCC. Patients in the treatment group (n = 43) received lamivudine with or without adefovir dipivoxil, while the control group (n = 36) received no antiviral treatment. The treatment group had a significantly higher HBeAg seroconversion rate (57.2% vs. 5.6%) and a higher HBV DNA suppression rate (87.2% vs. 2.8%) after 12 months of antiviral treatment. The treatment group also had a significantly greater increase in residual liver volume per unit surface area following hepatectomy (78.0 +/- A 40.1 cm(3)/m(2) vs. 35.8 +/- A 56.0 cm(3)/m(2)) at 6-month postoperation. After a median follow-up of 12 months, there was no significant difference in recurrence rate after surgery between the treatment group and the control group (76.7% and 91.7%). There was a significant difference in the overall survival rate but not in the disease-free survival rate. The 1- and 2-year overall survival rates were 41.9% and 7.0%, respectively, for the treatment group, and 33.3% and 0%, respectively, for the control group. The 1- and 2-year disease-free survival rates were 23.3% and 2.3%, respectively, for the treatment group, and 8.3% and 0%, respectively, for the control group. Although nucleoside analogs did not reduce short-term recurrence rate, they promoted postoperative viral clearance and increased residual liver volume, which significantly enhanced tolerance to subsequent therapy for disease recurrence.
引用
收藏
页码:179 / 185
页数:7
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