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Lamivudine therapy improved tumor-free survival rate after curative resection of HBV-related HCC in patients with high serum concentrations of HBV DNA, although careful follow up proved necessary for the detection of YMDD mutant viruses.

E PREVIOUSLY REPORTED a 2-year study showing that vitamin K 2 (menaquinone) helps to prevent bone loss in women with viral cirrhosis of the liver. 1 Most of the women agreed to participate in a longer study to clarify the long-term effects of vitamin K 2 on bone loss associated with cirrhosis. The incidence of hepatocellular carcinoma was found to differ between women who received vitamin K 2 and those who did not. METHODSThe participants in this study were 50 women with viral liver cirrhosis who were admitted to a university hospital between 1996 and 1998. When the results of abdominal dynamic computed tomography and abdominal ultrasonography suggested the presence of hepatocellular carcinoma, abdominal angiography or needle biopsy was performed to confirm the diagnosis. The diagnosis of cirrhosis was based on histological examination of liver specimens obtained by laparoscopy or needle biopsy performed under ultrasonic guidance.Hepatocellular carcinoma was cofirmed in 3 women in the treatment group and 4 in the control group. These 7 women were excluded from further study. The remaining 43 women were randomly assigned using sealed envelopes to a treatment or control group. The treatment group received 45 mg/d of vitamin K 2 (Glakay, Eisai Co, Tokyo, Japan). At the end of the first study, 21 women in the treatment group and 19 in the control group consented to participate in a longer trial. All but 1 woman in each group had hepatitis C

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