Tenofovir vs. entecavir on recurrence of hepatitis B virus-related hepatocellular carcinoma beyond Milan criteria after hepatectomy.
10.1097/CM9.0000000000001864
- VernacularTitle:Tenofovir
vs. entecavir on recurrence of hepatitis B virus-related hepatocellular carcinoma beyond Milan criteria after hepatectomy
- Author:
Junyi SHEN
1
;
Weili QI
1
;
Junlong DAI
1
;
Shusheng LENG
2
;
Kangyi JIANG
3
;
Yu ZHANG
4
;
Shun RAN
5
;
Chuan LI
1
;
Tianfu WEN
1
Author Information
1. Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
2. Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Chengdu University, Chengdu, Sichuan 610072, China.
3. Department of Hepatobiliary and Pancreatic Surgery, The People's Hospital of Leshan, Leshan, Sichuan 614700, China.
4. Department of Hepatobiliary Surgery, Sichuan Provincial People's Hospital, Chinese Academy of Sciences, Chengdu, Sichuan 610072, China.
5. Department of Hepatobiliary Surgery, Affiliated Cancer Hospital of Guizhou Medical University, Guiyang, Guizhou 550000, China.
- Publication Type:Journal Article
- MeSH:
Antiviral Agents/therapeutic use*;
Carcinoma, Hepatocellular/surgery*;
Guanine/analogs & derivatives*;
Hepatectomy;
Hepatitis B virus;
Hepatitis B, Chronic/drug therapy*;
Humans;
Liver Neoplasms/surgery*;
Retrospective Studies;
Tenofovir/therapeutic use*
- From:
Chinese Medical Journal
2021;135(3):301-308
- CountryChina
- Language:English
-
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.
