Abstract:
Objective The effect of antiviral therapy for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after radical hepatectomy was assessed.
Methods A total of 478 HBV-HCC patients treated by radical hepatectomy were retrospectively collected. Patients in the treatment group (n=141) received postoperative lamivudine therapy (100 mg/d), whereas patients in the control group (n=337) did not. Recurrence-free survival rates, overall survival rates, treatments for recurrent HCC and cause of death were compared between the two groups. Propensity score matching was also conducted to reduce confounding bias between the groups.
Results The one-, three-, and five-year recurrence-free survival rates didn't significantly differ between the two groups (P=0.778); however, the one-, three-, and five-year overall survival rates in the treatment group were significantly higher than those in the control group (P= 0.002). Similar results were observed in the matched data. Subgroup analysis showed that antiviral treatment conferred a significant survival benefit for Barcelona Clinical Liver Cancer stage A/B patients. Following HCC recurrence, more people in the treatment group were able to choose curative treatments than those in the control group (P=0.031). For cause of death, fewer people in the treatment group died of liver failure than those in the control group (P=0.041).
Conclusion Postoperative antiviral therapy increases chances of receiving curative treatments for recurrent HCC and prevents death because of liver failure, thereby significantly prolonging overall survival, especially in early- or intermedian-stage tumors.