Meta-analysis: the efficacy of anti-viral therapy in prevention of recurrence after curative treatment of chronic hepatitis B-related hepatocellular carcinoma

Wong, John; Wong, Grace Lai–Hung; Tsoi, Kelvin K.; Wong, Vincent Wai‐Sun; Cheung, Siu Wun; Chong, Charing Ching‐Ning; Lee, K.-F.; Lai, Paul B.S.; Chan, Henry Lik‐Yuen

doi:10.1111/j.1365-2036.2011.04634.x

Cited by 163 publications

(146 citation statements)

References 33 publications

(74 reference statements)

Supporting

Mentioning

131

Contrasting

Unclassified

Order By: Relevance

“…It has been reported that nucleoside/nucleotide analogs (NA) in hepatitis Brelated HCC (B-HCC) and interferon (IFN)-based therapy in hepatitis C-related HCC (C-HCC) had beneficial effects in terms of preventing recurrence and preserving liver function. [12][13][14] However, these trials enrolled only selected patients with specific conditions. It is not well documented whether the prognosis outside of clinical trials actually improved following radical percutaneous therapy.…”

Section: Introductionmentioning

confidence: 99%

Comparison of improved prognosis between hepatitis B‐ and hepatitis C‐related hepatocellular carcinoma

Minami

Tateishi

Shiina

et al. 2015

Hepatology Research

View full text Add to dashboard Cite

Aim: Treatment strategies for hepatocellular carcinoma (HCC) have been advanced. The aim of this study was to compare the change of the prognosis between hepatitis B-related HCC (B-HCC) and hepatitis C-related HCC (C-HCC) in the last two decades. Results: Two (11%), 24 (49%) and 80 (82%) B-HCC patients received nucleoside/nucleotide analogs during the follow-up period in cohorts 1-3, respectively. Among them 1, 18 and 62 patients achieved viral remission, respectively. Thirty-four (18%), 35 (8%) and 84 (14%) C-HCC patients received interferon therapy, respectively. The 5-year B-HCC (P < 0.001) survival rates were 52.6%, 61.1% and 81.6% for cohorts 1-3, respectively. However, the survival rates were 55.6%, 58.8% and 61.1% for C-HCC (P = 0.12), respectively. The B-HCC prognosis improved dramatically (P < 0.001) over time, whereas the prognosis of C-HCC improved moderately (P = 0.01). Methods: Conclusion:The prognosis of B-HCC has improved dramatically over time, whereas that of C-HCC has improved moderately.

show abstract

Section: Introductionmentioning

confidence: 99%

Comparison of improved prognosis between hepatitis B‐ and hepatitis C‐related hepatocellular carcinoma

Minami

Tateishi

Shiina

et al. 2015

Hepatology Research

View full text Add to dashboard Cite

show abstract

“…El beneficio de terapia neoadyuvante o adyuvante se ha estudiado en múltiples trabajos sin que por el momento se encontraran evidencias que justifiquen su uso estandarizado, aunque algunos tratamientos antivirales podrían ofrecer beneficios 40 .…”

Section: Resección Hepáticaunclassified

Hepatocarcinoma: estado actual

2014

Gal. Clin.

View full text Add to dashboard Cite

ResumenEl carcinoma hepatocelular (CHC) es la neoplasia primaria hepática más frecuente. Constituye el sexto tumor más habitual en el mundo, con más de 500.000 casos diagnosticados cada año y es la tercera causa más común de muerte por cáncer. Esta enfermedad afecta de manera casi exclusiva a pacientes con hepatopatía crónica que han desarrollado cirrosis, especialmente la relacionada con los virus de la hepatitis B y C, siendo en este grupo de sujetos el CHC la causa más frecuente de muerte. La incidencia del hepatocarcinoma varía ampliamente a lo largo de la geografía mundial. Se han descrito tasas de 2 a 50 casos por 100.000 habitantes al año, en correlación a la epidemiología de sus factores de riesgo y la distribución de los diversos genotipos virales. Las zonas más prevalentes son el Sudeste Asiático y el África Subsahariana, donde la infección por el virus de la hepatitis B (VHB) es endémica. Los estudios más recientes objetivan un aumento mundial en la incidencia del CHC, incluyendo los países occidentales, debido a la mayor diseminación del virus de la hepatitis C (VHC) en las décadas de los 60 y 70 además de un aumento en el consumo excesivo de alcohol . La elevada complejidad de esta neoplasia y las patologías con las que se haya íntimamente relacionada, hacen necesario un abordaje multidisciplinar para su manejo, implicando a múltiples especialidades tanto médicas como quirúrgicas. AbstractHepatocellular carcinoma ranks among the most common primary liver malignancy and the sixth most frequently diagnosed cancer worldwide. More than 500.000 cases are diagnosed each year making this pathology the third leading cause of cancer-related death in the world. This disease affects almost exclusively to chronic liver patients who have developed cirrhosis, especially the one related to hepatitis B and C virus infection. Hepatocellular carcinoma is the leading cause of death in this group. The incidence of Hepatocellular carcinoma varies widely according to geographic location. Incidence rates from 2 to more than 50 cases per 100.000 inhabitants per year have been described. These differences in the distribution of HC are probably due to regional variations in the exposure to different risk factors and viral genotypes. The most prevalent areas include Southeastern Asia and Sub-Saharan Africa where hepatitis B viral infection is endemic. The hepatocellular carcinoma incidence is increasing worldwide. This includes western countries due to the increased spread of hepatitis C virus infection in the mid 1960s and 1970s, combined with an increase in excesive alcohol consumption in that area. The high complexity that distiguish both this neoplasm and the pathology which has been closely related to, deserves a multidisciplinary approach with multiple medical and surgical specialties to guarantee an appropiate management. EpidemiologíaSe han estratificado las diversas regiones del mundo en función del riesgo de desarrollo de CHC. Las áreas de elevada incidencia se caracterizan por presentar un número superior a 15 caso...

show abstract

“…Meta-analysis of these studies have concluded that NA therapy is associated with significantly lower tumor recurrence and liver-related mortality and significantly higher OS in patients with HBV-related HCC than no adjuvant therapy after curative treatments [20,21]. Unfortunately, the retrospective design of these studies limits the strength of their evidence.…”

mentioning

confidence: 98%

Nucleos(t)ide analogue therapy for HBV-related HCC after hepatic resection: clinical benefits and unanswered questions

Zhong

2014

Tumor Biol.

View full text Add to dashboard Cite

Hepatic resection (HR) and radiofrequency ablation (RFA) remain the most frequent curative therapies for hepatocellular carcinoma (HCC) because of strict indications for liver transplantation and shortages of donated livers. Nevertheless, recurrence occurs in up to 75 % of patients with intermediate or advanced HCC at 5 years after HR [1]; in these patients, 5-year recurrence-free survival (RFS) is lower than 25 %, and tumor recurrence is the main cause of death [2]. Therefore, inhibiting tumor recurrence is a key to improving HCC patients' overall survival (OS).Hepatitis B virus (HBV) is the most common cause of HCC around the world, which inspired clinicians to treat patients with HBV-related HCC using nucleos(t)ide analogues (NAs) to inhibit HBV replication and therefore reduce risk of HCC incidence. High HBV load and replication are associated with greater risk of HCC incidence [3], and large studies with long follow-up have shown that NA therapy can dramatically reduce HCC incidence and death in patients with liver cirrhosis who are chronically infected with HBV [4,5]. NA therapy also appears to reduce risk of HCC recurrence after HR [6,7], suggesting that it may improve OS for patients with HBVrelated HCC after curative HR or RFA.Many retrospective studies have suggested that adjuvant NA therapy does reduce risk of HBV-related HCC recurrence after curative treatments [7][8][9][10][11][12][13][14][15][16][17][18][19]. Meta-analysis of these studies have concluded that NA therapy is associated with significantly lower tumor recurrence and liver-related mortality and significantly higher OS in patients with HBV-related HCC than no adjuvant therapy after curative treatments [20,21]. Unfortunately, the retrospective design of these studies limits the strength of their evidence. The strongest evidence of whether NA therapy offers clinical benefits would come, in principle, from a randomized controlled trial (RCT). However, carrying out an RCT is ethically and logistically difficult because oral NA therapy has already proven effective at preventing disease progression in patients chronically infected with HBV and because such therapy is becoming more affordable and does not cause significant side effects. Therefore, few patients with HBV-related HCC would volunteer for an RCT.Despite these obstacles, Yin et al. managed to publish in 2013 the first RCT examining the efficacy of adjuvant NA therapy in 180 patients newly diagnosed with HBV-related HCC after curative HR [22]. All patients had serum HBV DNA levels greater than 100 IU/mL. After median follow-up of 39.9 months, per-protocol analysis revealed that patients receiving lamivudine (100 mg/day) showed significantly higher short-and long-term RFS and OS than patients receiving no adjuvant therapy. In 2014, Huang and coworkers [23] performed an RCT examining the efficacy of adjuvant adefovir therapy in 200 patients newly diagnosed with HBVrelated HCC after curative HR. In contrast to the earlier RCT, all patients in this study had serum HBV DNA levels greater t...

show abstract

Meta-analysis: the efficacy of anti-viral therapy in prevention of recurrence after curative treatment of chronic hepatitis B-related hepatocellular carcinoma

Abstract: SUMMARY BackgroundThe role of anti-viral therapy in prevention of hepatocellular carcinoma (HCC) recurrence is to be defined.

Cited by 163 publications

References 33 publications

Comparison of improved prognosis between hepatitis B‐ and hepatitis C‐related hepatocellular carcinoma

Comparison of improved prognosis between hepatitis B‐ and hepatitis C‐related hepatocellular carcinoma

Hepatocarcinoma: estado actual

Nucleos(t)ide analogue therapy for HBV-related HCC after hepatic resection: clinical benefits and unanswered questions

Contact Info

Product

Resources

About