Perioperative remedial antiviral therapy in HBV-related HCC resection: how to get a better outcome

Abstract

AbstractBackground:Although the benefits of antiviral therapy against hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) have been proven, researchers have not confirmed the different outcomes between patients who had received a period of time (at least 24 weeks) or just received remedial antiviral therapy before radical resection for HBV-related HCC.Methods:A retrospective study of patients who underwent radical resection for HBV-related HCC at the First Affiliated Hospital of Xi'an Jiaotong University from January 2016 to June 2019 was conducted. Considering the history of antiviral therapy, patients were divided into remedial antiviral therapy and preoperative antiviral therapy groups.Results:The Kaplan–Meier analysis showed a significant difference in overall survival (P<0.0001) and disease-free survival (P=0.035) between the two groups. Multivariate analysis demonstrated that history of preoperative antiviral treatment was independently related to enhanced survival outcome in OS (HR 0.27; 95% CI= 0.08–0.88, P=0.030).Conclusions:In patients with HBV-related HCC, it is ideal to receive preoperative long-term antiviral therapy which help patients tolerate more extensive hepatectomy, but remedial antiviral therapy reducing preoperative HBV-DNA levels to less than 4 log10 copies DNA/ml can also resulted in enhanced outcomes.