Top

World Journal of Surgery

Published in:

01-09-2014

Antiviral Therapy Decreases Recurrence of Hepatitis B Virus-related Hepatocellular Carcinoma after Curative Resection: A Meta-analysis

Authors: Yanming Zhou, Zhansai Zhang, Yanfang Zhao, Lupeng Wu, Bin Li

Published in: World Journal of Surgery | Issue 9/2014

Abstract

Background

The long-term outcome after curative resection of hepatocellular carcinoma (HCC) remains unsatisfactory because of the high incidence of recurrence. The present study was intended to assess the impact of hepatitis B virus (HBV) DNA level and nucleos(t)ide analog therapy on posthepatectomy recurrence of HBV-related HCC.

Methods

Eligible studies were identified through a computerized literature search. The pooled relative risk ratio (RR) with 95 % confidence interval (CI) was calculated using Review Manager 5.1 Software.

Results

Twenty studies with a total of 8,204 participants were included for this meta-analysis. Pooled analysis showed that high viral load was significantly associated with risk of recurrence (RR: 1.85, 95 % CI: 1.41–2.42; P < 0.001), poorer disease-free survival (DFS) (RR: 1.96, 95 % CI: 1.62–2.38; P < 0.001), and poorer overall survival (OS) (RR: 1.47, 95 % CI: 1.22–1.77; P < 0.001) of HBV-related HCC after surgical resection. Nucleos(t)ide analog therapy significantly decreased the recurrence risk (RR: 0.69, 95 % CI: 0.59–0.80; P < 0.001) and improved both DFS (RR: 0.70, 95 % CI: 0.58–0.83; P < 0.001) and OS (RR: 0.46, 95 % CI: 0.32–0.68; P < 0.001).

Conclusions

High DNA level is associated with posthepatectomy recurrence of HBV-related HCC. Nucleos(t)ide analog therapy improves the prognosis of HBV-related HCC after resection.

El-Serag HB, Rudolph KL (2007) Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterology 132:2557–2576PubMedCrossRef

Papatheodoridis GV, Lampertico P, Manolakopoulos S et al (2010) Incidence of hepatocellular carcinoma in chronic hepatitis B patients receiving nucleos(t)ide therapy: a systematic review. J Hepatol 53:348–356PubMedCrossRef

Zhou Y, Sui C, Li B et al (2010) Repeat hepatectomy for recurrent hepatocellular carcinoma: a local experience and a systematic review. World J Surg Oncol 8:55PubMedCentralPubMedCrossRef

Tung-Ping Poon R, Fan ST, Wong J (2000) Risk factors, prevention, and management of postoperative recurrence after resection of hepatocellular carcinoma. Ann Surg 232:10–24PubMedCentralPubMedCrossRef

Hung IF, Poon RT, Lai CL et al (2008) Recurrence of hepatitis B-related hepatocellular carcinoma is associated with high viral load at the time of resection. Am J Gastroenterol 103:1663–1673PubMedCrossRef

Kim BK, Park JY, Kim do Y et al (2008) Persistent hepatitis B viral replication affects recurrence of hepatocellular carcinoma after curative resection. Liver Int 28:393–401PubMedCrossRef

Kubo S, Tanaka H, Takemura S et al (2007) Effects of lamivudine on outcome after liver resection for hepatocellular carcinoma in patients with active replication of hepatitis B virus. Hepatol Res 37:94–100PubMedCrossRef

Piao CY, Fujioka S, Iwasaki Y et al (2005) Lamivudine treatment in patients with HBV-related hepatocellular carcinoma—using an untreated, matched control cohort. Acta Med Okayama 59:217–224PubMed

Kuzuya T, Katano Y, Kumada T et al (2007) Efficacy of antiviral therapy with lamivudine after initial treatment for hepatitis B virus-related hepatocellular carcinoma. J Gastroenterol Hepatol 22:1929–1935PubMedCrossRef

10.

Chuma M, Hige S, Kamiyama T et al (2009) The influence of hepatitis B DNA level and antiviral therapy on recurrence after initial curative treatment in patients with hepatocellular carcinoma. J Gastroenterol 44:991–999PubMedCrossRef

11.

Koda M, Nagahara T, Matono T et al (2009) Nucleotide analogs for patients with HBV-related hepatocellular carcinoma increase the survival rate through improved liver function. Intern Med 48:11–17PubMedCrossRef

12.

Li N, Lai EC, Shi J et al (2010) A comparative study of antiviral therapy after resection of hepatocellular carcinoma in the immune-active phase of hepatitis B virus infection. Ann Surg Oncol 17:179–185PubMedCrossRef

13.

Chan AC, Chok KS, Yuen WK et al (2011) Impact of antiviral therapy on the survival of patients after major hepatectomy for hepatitis B virus-related hepatocellular carcinoma. Arch Surg 146:675–681PubMedCrossRef

14.

Jadad AR, Moore RA, Carroll D et al (1996) Assessment the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17:1–12PubMedCrossRef

15.

Simillis C, Constantinides VA, Tekkis PP et al (2007) Laparoscopic versus open hepatic resections for benign and malignant neoplasms—a meta-analysis. Surgery 141:203–211PubMedCrossRef

16.

Parmar MK, Torri V, Stewart L (1998) Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints. Stat Med 17:2815–2834PubMedCrossRef

17.

Tierney JF, Stewart LA, Ghersi D et al (2007) Practical methods for incorporating summary time-to-event data into meta-analysis. Trials 8:16PubMedCentralPubMedCrossRef

18.

Cai X, Huang C, Zhou H et al (2008) Postoperative serum HBV DNA level evaluate the recurrence after radical resection for patients with HBV-related hepatocellular carcinoma [in Chinese]. J Fujian Med Univ 42:438–440

19.

Wu JC, Huang YH, Chau GY et al (2009) Risk factors for early and late recurrence in hepatitis B-related hepatocellular carcinoma. J Hepatol 51:890–897PubMedCrossRef

20.

An HJ, Jang JW, Bae SH et al (2010) Sustained low hepatitis B viral load predicts good outcome after curative resection in patients with hepatocellular carcinoma. J Gastroenterol Hepatol 25:1876–1882PubMedCrossRef

21.

Qu LS, Jin F, Huang XW et al (2010) High hepatitis B viral load predicts recurrence of small hepatocellular carcinoma after curative resection. J Gastrointest Surg 14:1111–1120PubMedCrossRef

22.

Yang M, Xiao L, Shi X (2010) A study of antiviral therapy in prevention of tumor recurrence after curative treatment of hepatocellular carcinoma [in Chinese]. Med J Chin PLA 35:726–732

23.

Yeh CT, So M, Ng J et al (2010) Hepatitis B virus-DNA level and basal core promoter A1762T/G1764A mutation in liver tissue independently predict postoperative survival in hepatocellular carcinoma. Hepatology 52:1922–1933PubMedCrossRef

24.

Cheng F, Lv L, Sun B et al (2011) A study of antiviral therapy in prevention of tumor recurrence after radical liver resection of hepatocellular carcinoma with high load of hepatitis B virus DNA [in Chinese]. Acta Univ Med Nanjing 31:882–888

25.

Choi JG, Chung YH, Kim JA et al (2012) High HBV-DNA titer in surrounding liver rather than in hepatocellular carcinoma tissue predisposes to recurrence after curative surgical resection. J Clin Gastroenterol 46:413–419PubMedCrossRef

26.

Feng J, Li J, Fang T et al (2012) The effect of adefovir dipivoxil on the prognosis of HBV positive hepatocellular carcinoma [in Chinese]. China Modern Doctor 50:50–54

27.

Urata Y, Kubo S, Takemura S et al (2012) Effects of antiviral therapy on long-term outcome after liver resection for hepatitis B virus-related hepatocellular carcinoma. J Hepatobiliary Pancreat Sci 19:685–696PubMedCrossRef

28.

Wu CY, Chen YJ, Ho HJ et al (2012) Association between nucleoside analogues and risk of hepatitis B virus–related hepatocellular carcinoma recurrence following liver resection. JAMA 308:1906–1914PubMedCrossRef

29.

Yang T, Lu JH, Zhai J et al (2012) High viral load is associated with poor overall and recurrence-free survival of hepatitis B virus-related hepatocellular carcinoma after curative resection: a prospective cohort study. Eur J Surg Oncol 38:683–691PubMedCrossRef

30.

Su CW, Chiou YW, Tsai YH et al (2013) The influence of hepatitis B viral load and pre-S deletion mutations on post-operative recurrence of hepatocellular carcinoma and the tertiary preventive effects by anti-viral therapy. PLoS One 8:e66457PubMedCentralPubMedCrossRef

31.

Yin J, Li N, Han Y et al (2013) Effect of antiviral treatment with nucleotide/nucleoside analogs on postoperative prognosis of hepatitis B virus-related hepatocellular carcinoma: a two-stage longitudinal clinical study. J Clin Oncol 31:3647–3655PubMedCrossRef

32.

Zhang Z, Geng X, Zhao H et al (2013) The clinical significance of antiviral therapy for hepatocellular carcinoma with positive HBV-DNA patients [in Chinese]. J Hepatobiliary Surg 21:177–180

33.

Tsai WL, Chung RT (2010) Viral hepatocarcinogenesis. Oncogene 29:2309–2324PubMedCentralPubMedCrossRef

34.

Manigold T, Rehermann B (2003) Chronic hepatitis B and hepatocarcinogenesis: does prevention of “collateral damage” bring the cure? Hepatology 37:707–710PubMedCrossRef

35.

Chen CJ, Yang HI, Su J et al (2006) Risk of hepatocellular carcinoma across a biological gradient of serum hepatitis B virus DNA level. JAMA 295:65–73PubMedCrossRef

36.

Mendy ME, Welzel T, Lesi OA et al (2010) Hepatitis B viral load and risk for liver cirrhosis and hepatocellular carcinoma in The Gambia, West Africa. J Viral Hepat 17:115–122PubMedCentralPubMedCrossRef

37.

Imamura H, Matsuyama Y, Tanaka E et al (2003) Risk factors contributing to early and late phase intrahepatic recurrence of hepatocellular carcinoma after hepatectomy. J Hepatol 38:200–207PubMedCrossRef

38.

Breitenstein S, Dimitroulis D, Petrowsky H et al (2009) Systematic review and meta-analysis of interferon after curative treatment of hepatocellular carcinoma in patients with viral hepatitis. Br J Surg 96:975–981PubMedCrossRef

39.

Lin SM, Sheen IS, Chien RN et al (1999) Long-term beneficial effect of interferon therapy in patients with chronic hepatitis B virus infection. Hepatology 29:971–975PubMedCrossRef

40.

Lo CM, Liu CL, Chan SC et al (2007) A randomized, controlled trial of postoperative adjuvant interferon therapy after resection of hepatocellular carcinoma. Ann Surg 245:831–842PubMedCentralPubMedCrossRef

41.

Chen LT, Chen MF, Li LA et al (2012) Long-term results of a randomized, observation-controlled, phase III trial of adjuvant interferon Alfa-2b in hepatocellular carcinoma after curative resection. Ann Surg 255:8–17PubMedCrossRef

42.

Wong JS, Wong GL, Tsoi KK et al (2011) Meta-analysis: the efficacy of anti-viral therapy in prevention of recurrence after curative treatment of chronic hepatitis B-related hepatocellular carcinoma. Aliment Pharmacol Ther 33:1104–1112PubMedCrossRef

43.

Qu LS, Liu JX, Kuai XL, et al (2013) Significance of viral status on recurrence of hepatitis B-related hepatocellular carcinoma after curative therapy: a meta-analysis. Hepatol Res. doi: 10.1111/hepr.12172

44.

Chung GE, Kim W, Lee JH et al (2011) Negative hepatitis B envelope antigen predicts intrahepatic recurrence in hepatitis B virus-related hepatocellular carcinoma after ablation therapy. J Gastroenterol Hepatol 26:1638–1645PubMedCrossRef

45.

Zhou Y, Zhao Y, Li B et al (2010) Meta-analysis of radiofrequency ablation versus hepatic resection for small hepatocellular carcinoma. BMC Gastroenterol 10:78PubMedCentralPubMedCrossRef

46.

McKay A, Mackenzie S, Sutherland FR et al (2006) Meta-analysis of pancreaticojejunostomy versus pancreaticogastrostomy reconstruction after pancreaticoduodenectomy. Br J Surg 93:929–936PubMedCrossRef

Title: Antiviral Therapy Decreases Recurrence of Hepatitis B Virus-related Hepatocellular Carcinoma after Curative Resection: A Meta-analysis
Authors: Yanming Zhou
Zhansai Zhang
Yanfang Zhao
Lupeng Wu
Bin Li
Publication date: 01-09-2014
Publisher: Springer US
Published in: World Journal of Surgery / Issue 9/2014
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-014-2586-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Antiviral Therapy Decreases Recurrence of Hepatitis B Virus-related Hepatocellular Carcinoma after Curative Resection: A Meta-analysis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 9/2014

Influence of Surgical Margins on the Outcome of Breast Cancer Patients: A Retrospective Analysis

A Modification of Radical Antegrade Modular Pancreatosplenectomy for Adenocarcinoma of the Left Pancreas: Significance of En Bloc Resection Including the Anterior Renal Fascia

Perioperative Care with Fast-Track Management in Patients Undergoing Pancreaticoduodenectomy

Laparoscopic Versus Open Incisional and Ventral Hernia Repair: A Systematic Review and Meta-analysis

How Much Do We Really Know About Statins and Transplant Vasculopathy?

Authors Reply to Letter to Editor: Primary Hyperparathyroidism: An Analysis of Failure of Parathyroidectomy