Perioperative antiviral therapy improves the prognosis of HBV DNA-negative patients with HBV-related hepatocellular carcinoma

ABSTRACT

Objective

To investigate the effect of perioperative antiviral therapy on the prognosis of hepatitis B virus (HBV) DNA-negative patients with HBV-related hepatocellular carcinoma (HCC).

Methods

The clinical data of 140 patients who were positive for hepatitis B surface antigen (HBsAg) but negative for HBV DNA before partial hepatectomy were retrospectively analyzed. Propensity score matching (PSM) was used to eliminate the influence of confounding factors on prognosis. Postoperative liver function, HBV reactivation rate, recurrence-free survival (RFS) and overall survival (OS) were compared between antiviral and non-antiviral therapy groups.

Results

Compared with the non-antiviral therapy group, the antiviral therapy group had a lower rate of HBV reactivation and better postoperative liver function (P < 0.05). The 1-year, 2-year and 3-year survival rates of the antiviral therapy group were better than those of the non-antiviral therapy group before or after PSM (P < 0.05). Prognostic analysis excluding 11 patients with HBV reactivation showed that perioperative antiviral therapy could significantly improve OS (P = 0.004), but had no significant effect on RFS (P = 0.056). Multivariate analyzes showed that antiviral therapy was associated with better OS.

Conclusion

Perioperative antiviral therapy can significantly reduce the risk of HBV reactivation and improve postoperative liver function, RFS and OS.

KEYWORDS:

• Hepatocellular carcinoma
• hepatectomy
• prognosis
• overall survival
• hepatitis B
• HBV DNA

Article highlights

• The present study is to investigate the effect of perioperative antiviral therapy on the postoperative prognosis of HBV DNA-negative patients with HCC.

• HBV reactivation rate, liver function, RFS and OS were compared between the two groups.

• Perioperative antiviral therapy can significantly reduce the rate of HBV reactivation and improve liver function within 1 month after hepatectomy.

• Antiviral therapy can significantly reduce tumor recurrence and improve OS. However, after excluding patients with HBV reactivation, antiviral therapy was not associated with a significant improvement in RFS.

Authors’ contributions

W Gong and B Xiang conceived the study. C Li and Z Li collected and analyzed the data. C Li drafted the manuscript. L Ma, B Xiang, J Zhong and L Li critically revised the manuscript. All authors have read and approved the final version to be published.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work was funded by the Guangxi Science and Technology Development Projects (14124003-4), the National Major Special Science and Technology Project (2017ZX10203207), the National Natural Science Foundation of China (81160262, 81260088), the Guangxi Medical and Health Appropriate Technology Development and Promotion Application Project (S2019045), the Self-Raised Scientific Research Fund of the Ministry of Health of Guangxi Province (grant number Z2015601), and the ‘Guangxi BaGui Scholars’ Special Fund.