Impact of preoperative hepatitis B virus DNA load on prognosis of hepatocellular carcinoma patients undergoing hepatectomy
10.3760/cma.j.cn113884-20200616-00323
- VernacularTitle:术前乙型肝炎病毒DNA载量对肝细胞癌患者肝切除术后预后的影响
- Author:
Haotian LIU
1
;
Kang CHEN
;
Zhujian DENG
;
Minjun LI
;
Xiumei LIANG
;
Liang MA
;
Bangde XIANG
;
Jianhong ZHONG
;
Lequn LI
Author Information
1. 广西医科大学附属肿瘤医院肝胆外科 广西肝癌诊疗工程技术研究中心，南宁 530021
- Keywords:
Carcinoma, hepatocellular;
Hepatectomy;
Hepatitis B virus;
DNA;
Overall survival
- From:
Chinese Journal of Hepatobiliary Surgery
2021;27(6):429-433
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the impact of preoperative serum HBV DNA levels on prognosis of hepatocellular carcinoma (HCC) patients undergoing hepatectomy with curative intent.Methods:The clinical data of patients with HCC treated by hepatectomy with curative intent at the Guangxi Medical University Cancer Hospital from January 2010 to December 2016 were retrospectively analyzed. According to the preoperative serum HBV DNA levels, patients were divided into three groups: the control group (HBV DNA negative), the low load group (<10 4 copy/ml) and the high load group (≥10 4 copy/ml). The clinical data of these patients were collected and long-term survival outcomes of these patients were followed-up. The Kaplan-Meier method was used to compare the overall survival (OS) and recurrence-free survival (RFS) rates among the three groups. Using the Barcelona clinic liver cancer classification (BCLC), patients with different serum HBV DNA levels were further divided into three subgroups: stage 0/A, stage B and stage C. The OS and RFS rates of patients in each of these subgroups were compared. Results:Of 1 180 patients who were enrolled in the study, there were 1 024 males and 156 females, aged (48.6±10.8) years. The 1-, 3- and 5-year OS rates for patients in the control group ( n=258) were 91.5%, 79.3% and 74.9%, respectively; while those in the low load group ( n=289) were 87.2%, 68.6% and 61.6%, respectively; and those in the high load group ( n=633) were 85.4%, 68.9% and 60.7%, respectively. The 1-, 3- and 5-year OS rates in the control group were significantly better than those in the low load group and the high load group ( P<0.05). The 1-, 2- and 3-year RFS rates in the control group were significantly higher than those in the high load group ( P<0.05). Subgroup analysis showed that in the BCLC 0/A subgroup ( n=786) the 1-, 3- and 5-year OS rates in the control group were significantly better than those in the high load group ( P<0.05). In the BCLC B subgroup ( n=181), the 1-, 2- and 3-year RFS rates in the control group were significantly higher than those in the high load group ( P<0.05). In the BCLC C subgroup ( n=214), there were no significant differences in the 1-, 3- and 5-year OS and 1-, 2- and 3-year RFS rates among the three groups ( P>0.05). Conclusion:For HCC patients undergoing hepatectomy with curative intent, the higher the preoperative serum HBV-DNA level, the worse the long-term survival outcomes.
