Tenofovir vs. entecavir on recurrence of hepatitis B virus-related hepatocellular carcinoma beyond Milan criteria after hepatectomy

Abstract

Background:Hepatectomy for hepatocellular carcinoma (HCC) beyond the Milan criteria is shown to be beneficial. However, a high rate of post-operative HCC recurrence hinders the long-term survival of the patients. This study aimed to investigate and compare the impacts of tenofovir (TDF) and entecavir (ETV) on the recurrence of hepatitis B viral (HBV)-related HCC beyond the Milan criteria.Methods:Data pertaining to 1532 patients who underwent hepatectomy and received antiviral therapy between January 2014 and January 2019 were collected from five centers. Recurrence-free survival (RFS) analysis was performed using the Kaplan–Meier method. Cox proportional hazards regression analysis was performed to determine prognostic factors for HCC recurrence.Results:The analysis incorporates 595 HBV-related HCC patients. The overall 5-year RFS was 21.3%. Among them, 533 and 62 patients received ETV and TDF treatment, respectively. The 1-, 3-, and 5-year RFS rates were 46.3%, 27.4%, and 19.6%, respectively, in the ETV group compared with 65.1%, 41.8%, and 37.2%, respectively, in the TDF group (P < 0.001). Multivariate analysis showed that TDF treatment (hazard ratio [HR]: 0.604, P = 0.005), cirrhosis (HR: 1.557, P = 0.004), tumor size (HR: 1.037, P = 0.008), microvascular invasion (MVI) (HR: 1.403, P = 0.002), portal vein tumor thrombus (PVTT) (HR: 1.358, P = 0.012), capsular invasion (HR: 1.228, P = 0.040), and creatinine levels (CREA) (HR: 0.993, P = 0.031) were statistically significant prognostic factors associated with RFS.Conclusions:Patients with HCC beyond the Milan criteria exhibited a high rate of HCC recurrence after hepatectomy. Compared to the ETV therapy, TDF administration significantly lowered the risk of HCC recurrence.

Tenofovir versus entecavir for tertiary prevention of hepatocellular carcinoma in chronic hepatitis B infection after curative therapy: A systematic review and meta‐analysis

“…TDF was associated with a lower risk of recurrence compared to ETV [unadjusted HR (uHR) 0.88, 95% CI 0.80–0.97; I 2 = 44.9%] with a low heterogeneity among the studies (Figure S1). On pooling the aHR reported in 7 studies, 18,19,21,22,24–26 TDF was still associated with a lower risk of recurrence (aHR 0.73, 95% CI 0.65–0.81; I 2 = 67.7%), but with a moderate heterogeneity (Figure 2). Concerning the timing of recurrence reported in 5 studies, 19–21,23,25 TDF reduced the risk of late recurrence compared to ETV (aHR 0.58, 95% CI 0.45–0.76; I 2 = 0.0%) but not early recurrence (aHR 0.88, 95% CI 0.76–1.02; I 2 = 34.8%) (Figure 3).…”

“…The search strategy yielded 769 records, of which nine studies [18][19][20][21][22][23][24][25][26] were included in the final analysis. Figure 1 shows the PRISMA flowchart for the study selection and inclusion process.…”

“…All the included studies were from Asia. All the studies were retrospective, except for the study by Lee et al 21 Patients underwent resection in seven studies [18][19][20]22,[24][25][26] radiofrequency ablation in one study. 23 The study by Lee et al 21 S1 shows the detailed study quality assessment using NOS.…”

The Roles and Pathogenesis Mechanisms of a Number of Micronutrients in the Prevention and/or Treatment of Chronic Hepatitis, COVID-19 and Type-2 Diabetes Mellitus

“…The roles of serum zinc (Zn) and methallothionein in acute versus chronic hepatitis C virus (HCV) [4], are shown in Figure 1. IFN-L3 is a proinflammatory cytokine, which has shown a potent antiviral activity against both acute and chronic infections [81]. In a recent study, zinc (Zn) was found to IFN-L3 is a proinflammatory cytokine, which has shown a potent antiviral activity against both acute and chronic infections [81].…”

“…IFN-L3 is a proinflammatory cytokine, which has shown a potent antiviral activity against both acute and chronic infections [81]. In a recent study, zinc (Zn) was found to IFN-L3 is a proinflammatory cytokine, which has shown a potent antiviral activity against both acute and chronic infections [81]. In a recent study, zinc (Zn) was found to cause an inhibition of the IFN-L3 binding to its receptor (IFNLR1).…”