The impact of antiviral therapy on the outcome of hepatitis B viral (HBV)-related hepatocellular carcinoma (HCC) detected in surveillance prorgram
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摘要Background: The role of antiviral therapy (AT) on the outcome of established HBV-related HCC is unclear. Based on two independent prospective cohorts on surveillance of HCC (Mok et al. J Clin Oncol 23:8041-7,05 and Chan et al. Hepatology 31:763- 8,00), we aimed to evaluate the impact of AT on the outcome of HCC.

Methods: All HCC cases in the two cohorts were identified. The baseline demographics, tumor features/stage, laboratory parameters at the time of HCC diagnosis, together with virologic factors (HBV genotype and DNA) and anticancer therapy were reviewed. The use and duration of AT was documented retrospectively. Univariate and multivariate analyses were conducted. Overall survival was the primary endpoint.

Results: 148 HCC were confirmed amongst 1,429 HBV carriers in the surveillance programs over 10 yrs median follow-up. Median age=58; 116M:32F. Most had early-stage HCC (TNM stage I/II=59.5%). 52 pts received AT during surveillance while 45 (86.5%) continued AT after the diagnosis of HCC. There were no differences in the baseline characteristics, tumor stage, and number of tumors between pts with or without AT. Pts with AT had significantly longer median OS (5.34 vs. 1.44 years; p=0.0003). Exploratory analyses found that pts on AT had higher albumin, better Child-Pugh stage, lower ALT, and were more likely to undergo surgery (46.2% vs. 25.0%; p=0.009) than pts without AT (Table). Longer duration of AT was associated with better OS (>12 ms vs. ≤12 ms; HR=0.28, 95%C.I.=0.12-0.63; p=0.0023). In multivariate analysis, use of AT>12ms remained to be a significant prognostic factor (HR=0.35, 95% C.I.=0.19-0.66) after adjustment of tumor stage, liver function and ECOG.

Conclusions: AT is associated with a higher chance of curative surgery and longer survival for HCC detected in surveillance program. Use of AT>12 months is an independent prognostic factor.
著者Wong VW, Mo F, Liem GS, Mok T, Chan AT, Chan HL, Yeo W, Chan SL
期刊名稱Journal of Clinical Oncology
出版作品名稱JOURNAL OF CLINICAL ONCOLOGY
出版年份2010
月份5
卷號28
期次15
出版社American Society of Clinical Oncology
頁次4028 - 4028
國際標準期刊號0732-183X
語言英式英語
Web of Science 學科類別Oncology;Oncology

上次更新時間 2020-20-11 於 02:53