Clinical Benefit of Antiviral Agents for Hepatocellular Carcinoma Patients With Low Preoperative HBV-DNA Loads Undergoing Curative Resection: A Meta-Analysis
Background and AimsThe clinical benefit of adjuvant antiviral therapy after curative therapy for HCC in patients with high preoperative HBV-DNA loads has been studied widely but that in patients with low preoperative HBV-DNA loads remains controversial. The purpose of this study was to determine the...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-02-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.605648/full |
| _version_ | 1819315423114428416 |
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| author | Kai-Xuan Liu Jian-Guo Hong Rui Wu Zhao-Ru Dong Ya-Fei Yang Yu-Chuan Yan Chun-Cheng Yang Lun-Jie Yan Sheng-Yu Yao Hai-Chao Li Xu-Ting Zhi Tao Li |
| author_facet | Kai-Xuan Liu Jian-Guo Hong Rui Wu Zhao-Ru Dong Ya-Fei Yang Yu-Chuan Yan Chun-Cheng Yang Lun-Jie Yan Sheng-Yu Yao Hai-Chao Li Xu-Ting Zhi Tao Li |
| author_sort | Kai-Xuan Liu |
| collection | DOAJ |
| description | Background and AimsThe clinical benefit of adjuvant antiviral therapy after curative therapy for HCC in patients with high preoperative HBV-DNA loads has been studied widely but that in patients with low preoperative HBV-DNA loads remains controversial. The purpose of this study was to determine the effect of antiviral treatment prophylaxis on HBV reactivation, overall survival (OS), and postoperative liver function in patients with low preoperative HBV-DNA levels undergoing curative resection.MethodsA meta-analysis was conducted by searching Web of Science, PubMed, Embase, and Cochrane Library until May 2020. We used REVMAN for data analysis and completed the study under the PRISMA guidelines.ResultsThree randomized trials and seven cohort studies, comprising of 1,131 individuals, were included in the meta-analysis. Antiviral treatment significantly reduced the rate of HBV reactivation after curative treatment of HCC, with a pooled risk ratio of 0.12 (95% c.i. 0.07 to 0.21; P < 0.00001). The trials were consistently favorable for the antiviral group, with a pooled hazard ratio of 0.52 (95% c.i. 0.37 to 0.74; P = 0.0002) in respect of OS rate. However, by pooling the data from studies that reported ALT on the 30th day postoperatively, the result didn’t reach statistical significance (mean difference −4.38, 95% c.i. −13.83 to 5.07; P = 0.36). The I² values of the heterogeneity test for the above three comparisons are zero.ConclusionAntiviral therapy during curative resection is effective in reducing HBV reactivation and improving OS rate in HCC patients with low viral load. |
| first_indexed | 2024-12-24T09:59:52Z |
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| id | doaj.art-c7e2e4ca322145d28b7cd4781ee83ef4 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-24T09:59:52Z |
| publishDate | 2021-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-c7e2e4ca322145d28b7cd4781ee83ef42022-12-21T17:01:09ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-02-011110.3389/fonc.2021.605648605648Clinical Benefit of Antiviral Agents for Hepatocellular Carcinoma Patients With Low Preoperative HBV-DNA Loads Undergoing Curative Resection: A Meta-AnalysisKai-Xuan LiuJian-Guo HongRui WuZhao-Ru DongYa-Fei YangYu-Chuan YanChun-Cheng YangLun-Jie YanSheng-Yu YaoHai-Chao LiXu-Ting ZhiTao LiBackground and AimsThe clinical benefit of adjuvant antiviral therapy after curative therapy for HCC in patients with high preoperative HBV-DNA loads has been studied widely but that in patients with low preoperative HBV-DNA loads remains controversial. The purpose of this study was to determine the effect of antiviral treatment prophylaxis on HBV reactivation, overall survival (OS), and postoperative liver function in patients with low preoperative HBV-DNA levels undergoing curative resection.MethodsA meta-analysis was conducted by searching Web of Science, PubMed, Embase, and Cochrane Library until May 2020. We used REVMAN for data analysis and completed the study under the PRISMA guidelines.ResultsThree randomized trials and seven cohort studies, comprising of 1,131 individuals, were included in the meta-analysis. Antiviral treatment significantly reduced the rate of HBV reactivation after curative treatment of HCC, with a pooled risk ratio of 0.12 (95% c.i. 0.07 to 0.21; P < 0.00001). The trials were consistently favorable for the antiviral group, with a pooled hazard ratio of 0.52 (95% c.i. 0.37 to 0.74; P = 0.0002) in respect of OS rate. However, by pooling the data from studies that reported ALT on the 30th day postoperatively, the result didn’t reach statistical significance (mean difference −4.38, 95% c.i. −13.83 to 5.07; P = 0.36). The I² values of the heterogeneity test for the above three comparisons are zero.ConclusionAntiviral therapy during curative resection is effective in reducing HBV reactivation and improving OS rate in HCC patients with low viral load.https://www.frontiersin.org/articles/10.3389/fonc.2021.605648/fullhepatocellular carcinomaHBV reactivationantiviral therapyprognosisHBV-DNA load |
| spellingShingle | Kai-Xuan Liu Jian-Guo Hong Rui Wu Zhao-Ru Dong Ya-Fei Yang Yu-Chuan Yan Chun-Cheng Yang Lun-Jie Yan Sheng-Yu Yao Hai-Chao Li Xu-Ting Zhi Tao Li Clinical Benefit of Antiviral Agents for Hepatocellular Carcinoma Patients With Low Preoperative HBV-DNA Loads Undergoing Curative Resection: A Meta-Analysis Frontiers in Oncology hepatocellular carcinoma HBV reactivation antiviral therapy prognosis HBV-DNA load |
| title | Clinical Benefit of Antiviral Agents for Hepatocellular Carcinoma Patients With Low Preoperative HBV-DNA Loads Undergoing Curative Resection: A Meta-Analysis |
| title_full | Clinical Benefit of Antiviral Agents for Hepatocellular Carcinoma Patients With Low Preoperative HBV-DNA Loads Undergoing Curative Resection: A Meta-Analysis |
| title_fullStr | Clinical Benefit of Antiviral Agents for Hepatocellular Carcinoma Patients With Low Preoperative HBV-DNA Loads Undergoing Curative Resection: A Meta-Analysis |
| title_full_unstemmed | Clinical Benefit of Antiviral Agents for Hepatocellular Carcinoma Patients With Low Preoperative HBV-DNA Loads Undergoing Curative Resection: A Meta-Analysis |
| title_short | Clinical Benefit of Antiviral Agents for Hepatocellular Carcinoma Patients With Low Preoperative HBV-DNA Loads Undergoing Curative Resection: A Meta-Analysis |
| title_sort | clinical benefit of antiviral agents for hepatocellular carcinoma patients with low preoperative hbv dna loads undergoing curative resection a meta analysis |
| topic | hepatocellular carcinoma HBV reactivation antiviral therapy prognosis HBV-DNA load |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2021.605648/full |
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