No abstract

Background Hepatitis B virus (HBV) reactivation impact negatively the prognosis of patients with HBV-related hepatocellular carcinoma (HCC). This study aimed to observe the effect of antiviral therapy (AVT) on viral reactivation and long-term outcomes after percutaneous radiofrequency ablation (PRFA) for HBV-related HCC. Methods Data on 538 patients between 2009 and 2013 were reviewed. Propensity score matching (PSM) analysis was used to adjust for differences in baseline features between patients who received AVT (AVT group) and did not receive it (non-AVT group). Logistic regression was used to identify the independent factors for viral reactivation. The tumor recurrence and overall survival (OS) rates were analyzed using the Kaplan–Meier method. Recurrence patterns were also investigated. Results HBV reactivation developed in 10.8% (58/538) of patients after PRFA. AVT was associated independently with decreased viral reactivation (odd ratio: 0.061, 95% confidence interval: 0.018–0.200). In 215 pairs of patients obtained after PSM, the AVT group had lower 1-, 3-, and 5-year recurrence rates (24%, 55%, and 67% vs 33%, 75%, and 85%, respectively) and higher 1-, 3-, and 5-year OS rates (100%, 67%, and 59% vs 100%, 52%, and 42%, respectively) than non-AVT group (P < 0.001 for both). Additionally, the relapses in distant hepatic segments and the late recurrence after 2 years of PRFA were significantly reduced in the AVT group (78/215 vs 111/215 vs., P = 0.001; 39/109 vs. 61/91, P = 0.012, respectively). Conclusions AVT reduced late and distal intrahepatic recurrence and improved OS in patients undergoing PRFA for HBV-related HCC by inhibiting viral reactivation.

Background: The study aimed to examine the impact of antiviral therapy (AVT) on hepatitis B virus (HBV) reactivation and long-term outcomes after percutaneous radiofrequency ablation (PRFA) for HBV-related hepatocellular carcinoma (HCC). Methods: Data on 538 consecutive patients who underwent PRFA for early-stage HBV-related HCC between 2009 and 2013 were reviewed. Propensity score matching (PSM) analysis was used to adjust for differences in baseline features between AVT and non-AVT groups. Tumor recurrence and overall survival (OS) rates were analyzed using the Kaplan-Meier method. Tumor recurrence patterns were also investigated. Logistic regression was used to identify the risk factors of viral reactivation. Results: After PSM, 215 pairs of patients were generated. The AVT group had a lower 1-, 3-, and 5-year tumor recurrence rates (24%, 55%, and 67% vs 33%, 75%, and 85%, respectively) and a higher 1-, 3-, and 5-year OS rates (100%, 67%, and 59% vs 100%, 52%, and 42%, respectively) than non-AVT group (P<0.001 for both). Additionally, the intrahepatic distant recurrence and the later recurrence beyond 2 years after PRFA were significantly reduced in the AVT group compared with the non-AVT group (111/215 vs. 78/215, P=0.001; 39/109 vs. 61/91, P=0.012, respectively). HBV reactivation developed in 10.8% of patients after PRFA. AVT was identified as one of the independent risk factors of viral reactivation (odd ratio: 0.061, 95% confidence interval: 0.018-0.200). Conclusions: AVT reduced recurrence rate and improved OS of HBV-related HCC patients undergoing PRFA, possibly by inhibiting viral reactivation and then decreasing intrahepatic distant recurrence and late recurrence.