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
ARTICLE HIGHLIGHTS
Research background
Antiviral therapy is an indispensable treatment for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC), especially for patients who need radical hepatectomy. Previous studies have focused mainly on the necessity of antiviral therapy, but there is no unified standard for perioperative antiviral therapy.
Research motivation
Several patients had HCC and HBV infection detected at the same time, so they received remedial treatment beginning in the perioperative period. The clinical efficacy of perioperative remedial antiviral treatment remains unclear.
Research objectives
This study was designed to investigate the outcome and potential influencing factors of perioperative remedial antiviral therapy in patients with operable HBV-related HCC. These results provide valuable information for the clinical treatment of HCC.
Research methods
A total of 108 pairs of patients with HBV-related HCC were divided into two groups. The control group was given long-term preoperative antiviral therapy. The observation group was treated with remedial antiviral therapy. The outcome of treatment in the two groups, HBV DNA level, and surgical classification, were evaluated.
Research results
The overall survival and disease-free survival of patients in the preoperative long-term antiviral group were better than those in the perioperative remedial antiviral group, regardless of the removal range. History of preoperative antiviral treatment was independently associated with longer survival.
Research conclusions
HBV-related HCC patients receiving preoperative long-term antiviral therapy achieve a better outcome after hepatectomy. For patients diagnosed with HCC whose HBV infection is first detected in the perioperative period, once the preoperative HBV DNA concentration decreases to less than 4 Log10 copies/mL, perioperative remedial antiviral treatment can also result in improved outcomes.
Research perspectives
The long-term efficacy of perioperative remedial antiviral therapy, such as in the HBV DNA status and hepatitis B surface antigens, should be further studied.
