Tenofovir versus entecavir on decreasing risk of HBV-related hepatocellular carcinoma recurrence after liver transplantation

Abstract Background Recent studies have proved that tenofovir disoproxil fumarate (TDF) is associated with a lower risk of hepatocellular carcinoma (HCC) occurrence in chronic hepatitis B (CHB) patients and HCC recurrence in patients who underwent hepatectomy when compared to ETV. However, it is unc...

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Main Authors: Jianming Yang, Yewu Chen, Haobin Sun, Xijian Zhang, Jianfeng Wang, Zhixing Liang, Binsheng Fu, Tong Zhang, Shuhong Yi, Yinan Deng, Yang Yang
Format: Article
Language:English
Published: BMC 2023-01-01
Series:Infectious Agents and Cancer
Subjects:
Online Access:https://doi.org/10.1186/s13027-022-00478-4
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author Jianming Yang
Yewu Chen
Haobin Sun
Xijian Zhang
Jianfeng Wang
Zhixing Liang
Binsheng Fu
Tong Zhang
Shuhong Yi
Yinan Deng
Yang Yang
author_facet Jianming Yang
Yewu Chen
Haobin Sun
Xijian Zhang
Jianfeng Wang
Zhixing Liang
Binsheng Fu
Tong Zhang
Shuhong Yi
Yinan Deng
Yang Yang
author_sort Jianming Yang
collection DOAJ
description Abstract Background Recent studies have proved that tenofovir disoproxil fumarate (TDF) is associated with a lower risk of hepatocellular carcinoma (HCC) occurrence in chronic hepatitis B (CHB) patients and HCC recurrence in patients who underwent hepatectomy when compared to ETV. However, it is unclear whether TDF and ETV treatment, which are both recommended as first-line antiviral agents to prevent the hepatitis B (HBV) recurrence after liver transplantation (LT), are associated with equivalent prognosis. We aim to compare risk of HCC recurrence and survival of patients recieving TDF or ETV after LT for HBV-related HCC. Method We performed a retrospective study including 316 patients who received treatment with ETV or TDF after LT for HBV-related HCC from 2015 January to 2021 Augest. The Recurrence-free survival (RFS) and overall survival (OS) of TDF and ETV groups were analyzed and compared by propensity score-matched (PSM), multivariable Cox regression analysis, competing risk analysis, sensitivity analyses and subgroup analyses. Result Compared with ETV, TDF therapy was associated with significantly higher RFS rates in the entire cohort (P < 0.01), PSM cohort (P < 0.01) and beyond-Milan cohort (P < 0.01). By multivariable analysis, TDF group was associated with significantly lower rates of HCC recurrence (HR, 0.33; 95%CI, 0.14–0.75; P < 0.01). In subgroup analyses, the similar results were observed in patients with following tumor characteristics: Maximum diameter plus number of viable tumor ≥ 5, with MIV or MAT, AFP at LT ≥ 20 ng/ml, and well or moderate tumor grade. Conclusion Tenofovir decrease risk of HBV-Related Hepatocellular Carcinoma recurrence after liver transplantation compared to Entecavir.
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spelling doaj.art-55e12ef7d58f4b14aed881b7448f19c02023-01-22T12:05:15ZengBMCInfectious Agents and Cancer1750-93782023-01-011811910.1186/s13027-022-00478-4Tenofovir versus entecavir on decreasing risk of HBV-related hepatocellular carcinoma recurrence after liver transplantationJianming Yang0Yewu Chen1Haobin Sun2Xijian Zhang3Jianfeng Wang4Zhixing Liang5Binsheng Fu6Tong Zhang7Shuhong Yi8Yinan Deng9Yang Yang10Guangdong Provincial Key Laboratory of Liver Disease Research, Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen UniversityGuangdong Provincial Key Laboratory of Liver Disease Research, Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen UniversityGuangdong Provincial Key Laboratory of Liver Disease Research, Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen UniversityGuangdong Provincial Key Laboratory of Liver Disease Research, Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen UniversityGuangdong Provincial Key Laboratory of Liver Disease Research, Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen UniversityGuangdong Provincial Key Laboratory of Liver Disease Research, Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen UniversityGuangdong Provincial Key Laboratory of Liver Disease Research, Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen UniversityGuangdong Provincial Key Laboratory of Liver Disease Research, Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen UniversityGuangdong Provincial Key Laboratory of Liver Disease Research, Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen UniversityGuangdong Provincial Key Laboratory of Liver Disease Research, Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen UniversityGuangdong Provincial Key Laboratory of Liver Disease Research, Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen UniversityAbstract Background Recent studies have proved that tenofovir disoproxil fumarate (TDF) is associated with a lower risk of hepatocellular carcinoma (HCC) occurrence in chronic hepatitis B (CHB) patients and HCC recurrence in patients who underwent hepatectomy when compared to ETV. However, it is unclear whether TDF and ETV treatment, which are both recommended as first-line antiviral agents to prevent the hepatitis B (HBV) recurrence after liver transplantation (LT), are associated with equivalent prognosis. We aim to compare risk of HCC recurrence and survival of patients recieving TDF or ETV after LT for HBV-related HCC. Method We performed a retrospective study including 316 patients who received treatment with ETV or TDF after LT for HBV-related HCC from 2015 January to 2021 Augest. The Recurrence-free survival (RFS) and overall survival (OS) of TDF and ETV groups were analyzed and compared by propensity score-matched (PSM), multivariable Cox regression analysis, competing risk analysis, sensitivity analyses and subgroup analyses. Result Compared with ETV, TDF therapy was associated with significantly higher RFS rates in the entire cohort (P < 0.01), PSM cohort (P < 0.01) and beyond-Milan cohort (P < 0.01). By multivariable analysis, TDF group was associated with significantly lower rates of HCC recurrence (HR, 0.33; 95%CI, 0.14–0.75; P < 0.01). In subgroup analyses, the similar results were observed in patients with following tumor characteristics: Maximum diameter plus number of viable tumor ≥ 5, with MIV or MAT, AFP at LT ≥ 20 ng/ml, and well or moderate tumor grade. Conclusion Tenofovir decrease risk of HBV-Related Hepatocellular Carcinoma recurrence after liver transplantation compared to Entecavir.https://doi.org/10.1186/s13027-022-00478-4Tenofovir disoproxil fumarateEntecavirNucleos(t)ide analoguesHepatocellular carcinomaRecurrenceLiver transplantation
spellingShingle Jianming Yang
Yewu Chen
Haobin Sun
Xijian Zhang
Jianfeng Wang
Zhixing Liang
Binsheng Fu
Tong Zhang
Shuhong Yi
Yinan Deng
Yang Yang
Tenofovir versus entecavir on decreasing risk of HBV-related hepatocellular carcinoma recurrence after liver transplantation
Infectious Agents and Cancer
Tenofovir disoproxil fumarate
Entecavir
Nucleos(t)ide analogues
Hepatocellular carcinoma
Recurrence
Liver transplantation
title Tenofovir versus entecavir on decreasing risk of HBV-related hepatocellular carcinoma recurrence after liver transplantation
title_full Tenofovir versus entecavir on decreasing risk of HBV-related hepatocellular carcinoma recurrence after liver transplantation
title_fullStr Tenofovir versus entecavir on decreasing risk of HBV-related hepatocellular carcinoma recurrence after liver transplantation
title_full_unstemmed Tenofovir versus entecavir on decreasing risk of HBV-related hepatocellular carcinoma recurrence after liver transplantation
title_short Tenofovir versus entecavir on decreasing risk of HBV-related hepatocellular carcinoma recurrence after liver transplantation
title_sort tenofovir versus entecavir on decreasing risk of hbv related hepatocellular carcinoma recurrence after liver transplantation
topic Tenofovir disoproxil fumarate
Entecavir
Nucleos(t)ide analogues
Hepatocellular carcinoma
Recurrence
Liver transplantation
url https://doi.org/10.1186/s13027-022-00478-4
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