Association of HBV DNA replication with antiviral treatment outcomes in the patients with early-stage HBV-related hepatocellular carcinoma undergoing curative resection
Abstract Background It remains unclear what the antiviral therapy affects disease-free survival (DFS) and overall survival (OS) of patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) at different tumor stages and baseline HBV DNA levels. In this study, we analyzed the associ...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2016-03-01
|
| Series: | Chinese Journal of Cancer |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40880-016-0089-z |
| _version_ | 1818209040419782656 |
|---|---|
| author | Jian-Lin Chen Xiao-Jun Lin Qian Zhou Ming Shi Sheng-Ping Li Xiang-Ming Lao |
| author_facet | Jian-Lin Chen Xiao-Jun Lin Qian Zhou Ming Shi Sheng-Ping Li Xiang-Ming Lao |
| author_sort | Jian-Lin Chen |
| collection | DOAJ |
| description | Abstract Background It remains unclear what the antiviral therapy affects disease-free survival (DFS) and overall survival (OS) of patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) at different tumor stages and baseline HBV DNA levels. In this study, we analyzed the association of antiviral treatment with DFS and OS based on the stratification of baseline HBV DNA load in early-stage (stages I and II) HCC patients. Methods We included 445 patients with early-stage HBV-related HCC who underwent curative resection, and then classified them into four subgroups based on baseline HBV DNA load and antiviral therapy stratification. The Kaplan–Meier and Cox regression analyses were performed to determine the association of clinical characteristics with survival. Results The median follow-up period was 74 months. For all patients, cumulative OS rates in the antiviral group were significantly higher than those in the non-antiviral group (log-rank test, P = 0.023), whereas no significant differences in DFS rates were observed. High baseline HBV DNA level was a risk factor associated with short DFS and OS in all patients. In patients with baseline HBV DNA levels ≥2000 IU/mL, antiviral treatment was significantly associated with prolonged DFS and OS (log-rank test, P = 0.041 and 0.001, respectively). In patients with HBV DNA levels <2000 IU/mL or undetectable, antiviral treatment did not show a significant benefit in prolonging DFS and OS. Conclusions High baseline HBV DNA levels are associated with poor prognosis in the patients with early-stage HCC, and the antiviral treatment could generate survival benefits for the patients. Therefore, antiviral treatment should be given for these patients. However, the effect of antiviral treatment on the patients with low viral load remains unclear, and further investigation is warranted. |
| first_indexed | 2024-12-12T04:54:23Z |
| format | Article |
| id | doaj.art-881c2a43c1954f069f8220063eb6d0d8 |
| institution | Directory Open Access Journal |
| issn | 1944-446X |
| language | English |
| last_indexed | 2024-12-12T04:54:23Z |
| publishDate | 2016-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Chinese Journal of Cancer |
| spelling | doaj.art-881c2a43c1954f069f8220063eb6d0d82022-12-22T00:37:24ZengBMCChinese Journal of Cancer1944-446X2016-03-0135111410.1186/s40880-016-0089-zAssociation of HBV DNA replication with antiviral treatment outcomes in the patients with early-stage HBV-related hepatocellular carcinoma undergoing curative resectionJian-Lin Chen0Xiao-Jun Lin1Qian Zhou2Ming Shi3Sheng-Ping Li4Xiang-Ming Lao5Department of Hepatobiliary Oncology, State Key Laboratory of Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Hepatobiliary Oncology, State Key Laboratory of Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterEpidemiology Research Unit, The First Affiliated Hospital of Sun Yat-sen UniversityDepartment of Hepatobiliary Oncology, State Key Laboratory of Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Hepatobiliary Oncology, State Key Laboratory of Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Hepatobiliary Oncology, State Key Laboratory of Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterAbstract Background It remains unclear what the antiviral therapy affects disease-free survival (DFS) and overall survival (OS) of patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) at different tumor stages and baseline HBV DNA levels. In this study, we analyzed the association of antiviral treatment with DFS and OS based on the stratification of baseline HBV DNA load in early-stage (stages I and II) HCC patients. Methods We included 445 patients with early-stage HBV-related HCC who underwent curative resection, and then classified them into four subgroups based on baseline HBV DNA load and antiviral therapy stratification. The Kaplan–Meier and Cox regression analyses were performed to determine the association of clinical characteristics with survival. Results The median follow-up period was 74 months. For all patients, cumulative OS rates in the antiviral group were significantly higher than those in the non-antiviral group (log-rank test, P = 0.023), whereas no significant differences in DFS rates were observed. High baseline HBV DNA level was a risk factor associated with short DFS and OS in all patients. In patients with baseline HBV DNA levels ≥2000 IU/mL, antiviral treatment was significantly associated with prolonged DFS and OS (log-rank test, P = 0.041 and 0.001, respectively). In patients with HBV DNA levels <2000 IU/mL or undetectable, antiviral treatment did not show a significant benefit in prolonging DFS and OS. Conclusions High baseline HBV DNA levels are associated with poor prognosis in the patients with early-stage HCC, and the antiviral treatment could generate survival benefits for the patients. Therefore, antiviral treatment should be given for these patients. However, the effect of antiviral treatment on the patients with low viral load remains unclear, and further investigation is warranted.http://link.springer.com/article/10.1186/s40880-016-0089-zHepatocellular carcinomaResectionHepatitis B virusPrognosisAntiviral therapy |
| spellingShingle | Jian-Lin Chen Xiao-Jun Lin Qian Zhou Ming Shi Sheng-Ping Li Xiang-Ming Lao Association of HBV DNA replication with antiviral treatment outcomes in the patients with early-stage HBV-related hepatocellular carcinoma undergoing curative resection Chinese Journal of Cancer Hepatocellular carcinoma Resection Hepatitis B virus Prognosis Antiviral therapy |
| title | Association of HBV DNA replication with antiviral treatment outcomes in the patients with early-stage HBV-related hepatocellular carcinoma undergoing curative resection |
| title_full | Association of HBV DNA replication with antiviral treatment outcomes in the patients with early-stage HBV-related hepatocellular carcinoma undergoing curative resection |
| title_fullStr | Association of HBV DNA replication with antiviral treatment outcomes in the patients with early-stage HBV-related hepatocellular carcinoma undergoing curative resection |
| title_full_unstemmed | Association of HBV DNA replication with antiviral treatment outcomes in the patients with early-stage HBV-related hepatocellular carcinoma undergoing curative resection |
| title_short | Association of HBV DNA replication with antiviral treatment outcomes in the patients with early-stage HBV-related hepatocellular carcinoma undergoing curative resection |
| title_sort | association of hbv dna replication with antiviral treatment outcomes in the patients with early stage hbv related hepatocellular carcinoma undergoing curative resection |
| topic | Hepatocellular carcinoma Resection Hepatitis B virus Prognosis Antiviral therapy |
| url | http://link.springer.com/article/10.1186/s40880-016-0089-z |
| work_keys_str_mv | AT jianlinchen associationofhbvdnareplicationwithantiviraltreatmentoutcomesinthepatientswithearlystagehbvrelatedhepatocellularcarcinomaundergoingcurativeresection AT xiaojunlin associationofhbvdnareplicationwithantiviraltreatmentoutcomesinthepatientswithearlystagehbvrelatedhepatocellularcarcinomaundergoingcurativeresection AT qianzhou associationofhbvdnareplicationwithantiviraltreatmentoutcomesinthepatientswithearlystagehbvrelatedhepatocellularcarcinomaundergoingcurativeresection AT mingshi associationofhbvdnareplicationwithantiviraltreatmentoutcomesinthepatientswithearlystagehbvrelatedhepatocellularcarcinomaundergoingcurativeresection AT shengpingli associationofhbvdnareplicationwithantiviraltreatmentoutcomesinthepatientswithearlystagehbvrelatedhepatocellularcarcinomaundergoingcurativeresection AT xiangminglao associationofhbvdnareplicationwithantiviraltreatmentoutcomesinthepatientswithearlystagehbvrelatedhepatocellularcarcinomaundergoingcurativeresection |