The prognostic significance of serum HBeAg on the recurrence and long‐term survival after hepatectomy for hepatocellular carcinoma: A propensity score matching analysis

Abstract

The effects of serum hepatitis B e antigen (HBeAg) on the prognosis of hepatocellular carcinoma (HCC) patients after hepatectomy remain controversial. Our aim was to explore the prognostic significance of serum HBeAg on the prognosis of patients with HCC using a propensity matching model. Between January 2009 and March 2015, 953 patients with HCC who underwent hepatectomy in West China Hospital were analysed. Propensity matching analysis was applied, and survival analysis was performed using the Kaplan-Meier method. Risk factors were identified by the Cox proportional hazards model. All patients with HCC were classified into an HBeAg(-) group (n = 775, 81.3%) or an HBeAg(+) group (n = 178, 18.7%). Patients with positive serum HBeAg had poorer recurrence-free survival and overall survival before and after propensity matching. Similar results were found in patients within the Milan criteria. For patients beyond the Milan criteria, the HBeAg(+) group had poor overall survival before and after propensity matching. In term of recurrence-free survival, there was no statistically significant impact after propensity matching (P = .055), although there was a trend for HBeAg(+) patient to have reduced recurrence-free survival. Positive serum HBeAg, positive HBV-DNA load, largest tumour size, multiple tumours, microvascular invasion and a high serum level of preoperative alpha-fetoprotein were risk factors for recurrence. Our propensity model confirmed that positive serum HBeAg had a negative impact on the recurrence and long-term survival irrespective of tumour stages. HBeAg seroconversion might be beneficial for reducing the rate of recurrence.

A-G Score Associated With Outcomes in Solitary Hepatocellular Carcinoma Patients After Hepatectomy

“…The presence of HBeAg commonly indicated active viral replication with ongoing inflammatory activity and the potential for sustained liver injury. A previous study has revealed that positive HBeAg was associated with an increased risk for HCC and HCC recurrence after hepatectomy (30,31). Consistently, we also confirmed it was related to prognosis in solitary HCC patients.…”

Baseline HBV‐DNA load plus AST/ALT ratio predicts prognosis of HBV‐related hepatocellular carcinoma after hepatectomy: A multicentre study

“…Many studies adopted as cut‐off value of 2,000 IU/ml for HBV‐DNA load 18 . In our previous and current studies, we demonstrated that HBV‐DNA load with the cut‐off value of 1,000 IU/ml could significantly aid to distingush prognosis 19 …”

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

“…[14] In HBV-related HCC, active viral replication was associated with HCC recurrence after hepatectomy. [15,16] Antiviral therapy could significantly inhibit viral reactivation and improve post-operative recurrence after hepatectomy. [17,18] Entecavir (ETV) and tenofovir (TDF), which were approved for use in China in 2006 and 2014, respectively, are currently the first-line treatment therapy for patients with HBV infection.…”

“…In HBV-related HCC, active viral replication was associated with HCC recurrence after hepatectomy [15,16] . Antiviral therapy could significantly inhibit viral reactivation and improve post-operative recurrence after hepatectomy [17,18] .…”