Impact of oral anti–hepatitis B therapy on the survival of patients with hepatocellular carcinoma initially treated with chemoembolization

Zhou, Zhifen; Xing, Zheng; Zhou, Qian; Shi, Ming; Zhang, Yaojun; Guo, Rong; Yuan, Yunfei; Chen, Min Shan; Lin, Xiao Jun; Lao, Xiang-Ming; Li, Sheng Ping

doi:10.1186/s40880-015-0017-7

Cited by 16 publications

(16 citation statements)

References 36 publications

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“…In addition, some reports have shown that antivirus therapy for HBV-positive patients was associated with prolonged OS after TACE. 43 , 44 Similarly, antivirus therapy was an independent prognostic factor in both multivariate analyses and the Fine and Gray regression model for HCC patients in this study. It was also suggested that the combining H101 with antivirus therapy may increase curative effects for HCC patients after TACE therapy, which requires further investigation.…”

Section: Discussionsupporting

confidence: 56%

Increased Overall Survival and Decreased Cancer-Specific Mortality in Patients with Hepatocellular Carcinoma Treated by Transarterial Chemoembolization and Human Adenovirus Type-5 Combination Therapy: a Competing Risk Analysis

Zhang

Lin

2018

Journal of Gastrointestinal Surgery

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BackgroundIn analyzing cancer patient survival data, the problem of competing risks is often ignored. This study used a competing risk approach to evaluate the efficacy of recombinant human type-5 adenovirus (H101) in patients with hepatocellular carcinoma (HCC) treated by transarterial chemoembolization (TACE).MethodsIn this retrospective study, 476 patients were included. The cumulative probabilities of cancer-specific mortalities were analyzed by the Kaplan-Meier (KM) method and a competing risk model. Competing risk regression was used to assess the predictive factors for cumulative cancer-specific mortalities.ResultsTwo hundred thirty-eight HCC patients received combination TACE and H101 therapy, and another 238 HCC patients received TACE therapy alone. For patients in the TACE with H101 group, estimated 1-, 2-, and 3-year overall survival (OS) rates were 61.0, 40.0, and 31.5%, respectively, while for patients in the TACE group, the estimated 1-, 2-, and 3-year OS rates were 55.0, 33.4, and 22.3%, respectively. The 1-, 2-, and 3-year cancer-specific mortality rates for patients in the TACE with H101 group vs. the TACE group were 37.3 vs. 42.0%, 55.7 vs. 63.5%, and 61.9 vs. 74.7%, respectively. Multivariate competing risk analysis established that a combination of TACE and H101 therapy was an independent factor in decreasing cancer-specific mortality.ConclusionsCompared with TACE therapy, patients who were diagnosed with unresectable HCC treated with combined TACE and H101 therapy had increased OS and decreased cancer-specific mortality. The survival benefit was more obvious in patients with elevated AFP, absence of metastasis, single tumor, enlarged tumor, and HBsAg-positivity.

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Section: Discussionsupporting

confidence: 56%

Increased Overall Survival and Decreased Cancer-Specific Mortality in Patients with Hepatocellular Carcinoma Treated by Transarterial Chemoembolization and Human Adenovirus Type-5 Combination Therapy: a Competing Risk Analysis

Zhang

Lin

2018

Journal of Gastrointestinal Surgery

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“…One study showed that sustained low HBV load below 2000 IU/mL was a strong protective factor for long-term DFS and OS after curative resection in HBV-related HCC [ 23 ]. In addition, the effect of NAs differs in patients with different tumor stages [ 16 , 29 ]. Therefore, HBV DNA level, tumor stage, and liver function should be considered before administration of NAs [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Association of HBV DNA replication with antiviral treatment outcomes in the patients with early-stage HBV-related hepatocellular carcinoma undergoing curative resection

et al. 2016

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BackgroundIt remains unclear what the antiviral therapy affects disease-free survival (DFS) and overall survival (OS) of patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) at different tumor stages and baseline HBV DNA levels. In this study, we analyzed the association of antiviral treatment with DFS and OS based on the stratification of baseline HBV DNA load in early-stage (stages I and II) HCC patients.MethodsWe included 445 patients with early-stage HBV-related HCC who underwent curative resection, and then classified them into four subgroups based on baseline HBV DNA load and antiviral therapy stratification. The Kaplan–Meier and Cox regression analyses were performed to determine the association of clinical characteristics with survival.ResultsThe median follow-up period was 74 months. For all patients, cumulative OS rates in the antiviral group were significantly higher than those in the non-antiviral group (log-rank test, P = 0.023), whereas no significant differences in DFS rates were observed. High baseline HBV DNA level was a risk factor associated with short DFS and OS in all patients. In patients with baseline HBV DNA levels ≥2000 IU/mL, antiviral treatment was significantly associated with prolonged DFS and OS (log-rank test, P = 0.041 and 0.001, respectively). In patients with HBV DNA levels <2000 IU/mL or undetectable, antiviral treatment did not show a significant benefit in prolonging DFS and OS.ConclusionsHigh baseline HBV DNA levels are associated with poor prognosis in the patients with early-stage HCC, and the antiviral treatment could generate survival benefits for the patients. Therefore, antiviral treatment should be given for these patients. However, the effect of antiviral treatment on the patients with low viral load remains unclear, and further investigation is warranted.

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“…The add‐on resection and/or ablation significantly reduced the uncertainty of the HCC outcome and was only impacted by the vascular invasion. We strongly recommend the add‐on resection and/or ablation after TACE whenever the patient is eligible …”

Section: Discussionmentioning

confidence: 99%

“…We strongly recommend the add-on resection and/or ablation after TACE whenever the patient is eligible. 48,50,60,61 A limitation of this retrospective study is that the patients were all recruited from a single center. However, our results are encouraging and will be helpful in future studies designed to verify or extend our findings to improve the prognosis of unresectable HCC treated with TACE.…”

Section: Discussionmentioning

confidence: 99%

Clinical conditions and treatment requirements for long‐term survival among hepatitis B‐related hepatocellular carcinoma initially treated with chemoembolization

Chen

Jian

et al. 2019

Cancer Medicine

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Objective Transarterial chemoembolization (TACE) is recommended to treat intermediate/advanced stage of hepatocellular carcinoma (HCC). However, the overall survival among initially TACE‐treated patients varies significantly. The clinical characterization of long‐term survival following TACE remains uncertain. We sought to identify clinical parameters and treatment requirements for long‐term survival among patients with hepatitis B‐related HCC who were initially treated with TACE. Materials and Methods The included patients with HCC were admitted to our cancer center between December 2009 and May 2015. Patients who survived for >3 years were compared with those who died within 3 years. The clinical and laboratory findings that were associated with the survival were also analyzed. Results One in six (17.9%) patients with HCC in this cohort survived for > 3 years after TACE. Body mass index (BMI) ≥ 23kg/m 2 , aspartate aminotransferase levels ≤ 40 U/L, an activated partial thromboplastin time ≤ 34 seconds, α‐fetoprotein (AFP) levels ≤ 25 ng/mL, antiviral therapy, tumor size ≤ 8 cm, solitary nodule, and the absence of vascular invasion were independently favorably associated with a 3‐year survival. An absence of vascular invasion was the only independent factor associated with 3‐year survival in patients who received resection and/or ablation after TACE. Conclusion In this cohort, a 3‐year survival was associated with BMI, antivirus treatment, tumor status, hepatic function, and AFP level. Distant metastasis did not negatively impact the long‐term survival among patients with hepatitis B‐related HCC initially treated with TACE. Vascular invasion was the single impediment to long‐term survival in patients who received add‐on resection and/or ablation after TACE.

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Impact of oral anti–hepatitis B therapy on the survival of patients with hepatocellular carcinoma initially treated with chemoembolization

Cited by 16 publications

References 36 publications

Increased Overall Survival and Decreased Cancer-Specific Mortality in Patients with Hepatocellular Carcinoma Treated by Transarterial Chemoembolization and Human Adenovirus Type-5 Combination Therapy: a Competing Risk Analysis

Increased Overall Survival and Decreased Cancer-Specific Mortality in Patients with Hepatocellular Carcinoma Treated by Transarterial Chemoembolization and Human Adenovirus Type-5 Combination Therapy: a Competing Risk Analysis

Association of HBV DNA replication with antiviral treatment outcomes in the patients with early-stage HBV-related hepatocellular carcinoma undergoing curative resection

Clinical conditions and treatment requirements for long‐term survival among hepatitis B‐related hepatocellular carcinoma initially treated with chemoembolization

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