Mu F, Hu LS, Xu K, Zhao Z, Yang BC, Wang YM, Guo K, Shi JH, Lv Y, Wang B. Perioperative remedial antiviral therapy in hepatitis B virus-related hepatocellular carcinoma resection: How to achieve a better outcome. World J Gastrointest Oncol 2024; 16(5): 1833-1848 [PMID: 38764825 DOI: 10.4251/wjgo.v16.i5.1833]
Corresponding Author of This Article
Bo Wang, PhD, Chief Doctor, Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi’an Jiaotong University, No. 277 Yanta Road, Xi’an 710061, Shaanxi Province, China. bobwang457@sina.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. May 15, 2024; 16(5): 1833-1848 Published online May 15, 2024. doi: 10.4251/wjgo.v16.i5.1833
Perioperative remedial antiviral therapy in hepatitis B virus-related hepatocellular carcinoma resection: How to achieve a better outcome
Fan Mu, Liang-Shuo Hu, Kun Xu, Zhen Zhao, Bai-Cai Yang, Yi-Meng Wang, Kun Guo, Jian-Hua Shi, Yi Lv, Bo Wang
Fan Mu, Liang-Shuo Hu, Zhen Zhao, Yi-Meng Wang, Kun Guo, Jian-Hua Shi, Yi Lv, Bo Wang, Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Kun Xu, Department of Anaesthesiology, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Bai-Cai Yang, Department of Gynaecology, Wenzhou Medical University Affiliated Jiaxing Women and Children Hospital, Jiaxing 314000, Zhejiang Province, China
Author contributions: Mu F, Hu LS, and Wang B designed the research study; Mu F, Hu LS, Xu K and Zhao Z performed the research; Zhao Z, and Wang YM performed data analysis; Yang BC, Guo K, Shi JH, and Lv Y collected the data of patients; Mu F, Hu LS, Xu K, and Wang B contributed to writing the manuscript, drafting conception. All authors have read and approved the final the final manuscript.
Supported byNational Natural Science Foundation of China, No. 82070649.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the First Affiliated Hospital of Xi’an Jiao Tong University, No. XJTU1AF2021LSK-414.
Informed consent statement: Informed consent form exempted.
Conflict-of-interest statement: There is no conflict of interest.
Data sharing statement: All data and materials are available from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bo Wang, PhD, Chief Doctor, Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi’an Jiaotong University, No. 277 Yanta Road, Xi’an 710061, Shaanxi Province, China. bobwang457@sina.com
Received: December 3, 2023 Peer-review started: December 3, 2023 First decision: January 15, 2024 Revised: January 25, 2024 Accepted: February 18, 2024 Article in press: February 18, 2024 Published online: May 15, 2024 Processing time: 158 Days and 5.7 Hours
Abstract
BACKGROUND
Although the benefits of antiviral therapy for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) have been proven, researchers have not confirmed the differences in patient outcomes between patients who received preoperative antiviral therapy for a period of time (at least 24 wk) and patients who received remedial antiviral therapy just before radical resection for HBV-related HCC.
AIM
To investigate the efficacy of perioperative remedial antiviral therapy in patients with 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 assigned to remedial antiviral therapy and preoperative antiviral therapy groups.
RESULTS
Kaplan–Meier analysis revealed significant differences in overall survival (P < 0.0001) and disease-free survival (P = 0.035) between the two groups. Multivariate analysis demonstrated that a history of preoperative antiviral treatment was independently related to improved survival (hazard ratio = 0.27; 95% confidence interval: 0.08-0.88; P = 0.030).
CONCLUSION
In patients with HBV-related HCC, it is ideal to receive preoperative long-term antiviral therapy, which helps patients tolerate more extensive hepatectomy; however, remedial antiviral therapy, which reduces preoperative HBV-DNA levels to less than 4 Log10 copies DNA/mL, can also result in improved outcomes.
Core Tip: Hepatocellular carcinoma (HCC) is the seventh most common cancer in the world and is usually associated with hepatitis B virus (HBV) infection. Radical resection and antiviral therapy are considered key clinical treatments for patients with HBV-related HCC. However, many patients have their HCC and HBV infection detected at the same time, so they receive remedial antiviral treatment beginning in the perioperative period, missing the opportunity for long-term preoperative antiviral therapy. Therefore, evaluating the clinical efficacy and relevant factors of perioperative remedial antiviral therapy will be valuable.
