Published online May 15, 2024. doi: 10.4251/wjgo.v16.i5.1833
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
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.
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.
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.
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.
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.
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.
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.