Lamivudine versus Entecavir for Newly Diagnosed Hepatitis B Virus-Related Hepatocellular Carcinoma.
- Author:
Jung Hee KIM
1
;
Dong Hyun SINN
;
Kyunga KIM
;
Hyeseung KIM
;
Geum Youn GWAK
;
Yong Han PAIK
;
Moon Seok CHOI
;
Joon Hyeok LEE
;
Kwang Cheol KOH
;
Seung Woon PAIK
Author Information
- Publication Type:Original Article
- Keywords: Antiviral agents; Hepatitis B, chronic; Carcinoma, hepatocellular; Potency; Survival
- MeSH: Antiviral Agents; Carcinoma, Hepatocellular*; Cohort Studies; Diagnosis; Hepatitis B virus; Hepatitis B*; Hepatitis B, Chronic; Hepatitis*; Humans; Lamivudine*; Mortality; Recurrence; Retrospective Studies; Risk Factors
- From:Gut and Liver 2016;10(6):939-947
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Antiviral therapy is a key component in the management of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) patients. However, whether the potent drug entecavir is more effective than a less potent drug, such as lamivudine, in HBV-related HCC is not clear. METHODS: A retrospective cohort of 451 newly diagnosed, HBV-related HCC patients without antiviral therapy at diagnosis, who started antiviral therapy with either entecavir (n=249) or lamivudine (n=202), were enrolled. RESULTS: The median survival was longer for the entecavir group than for the lamivudine group, and lamivudine use (vs entecavir) was an independent factor for mortality (hazard ratio [HR], 1.49; p=0.002). Lamivudine use (vs entecavir) was an independent risk factor for new-onset hepatic decompensation (HR, 1.67; p=0.010) in 318 patients without previous hepatic decompensation, and it was also an independent risk factor for recurrence after curative therapy (HR, 1.84; p=0.002) in 117 patients who received curative therapy. The findings were similar in a propensity score-matched cohort. CONCLUSIONS: Overall survival, decompensation-free survival, and recurrence-free survival were better in the entecavir-treated patients than in the lamivudine treated-patients, indicating that the potent antiviral drug should be the preferred choice in HBV-related HCC patients.
