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The influence of hepatitis B DNA level and antiviral therapy on recurrence after initial curative treatment in patients with hepatocellular carcinoma

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Title: The influence of hepatitis B DNA level and antiviral therapy on recurrence after initial curative treatment in patients with hepatocellular carcinoma
Authors: Chuma, Makoto Browse this author →KAKEN DB
Hige, Shuhei Browse this author →KAKEN DB
Kamiyama, Toshiya Browse this author
Meguro, Takashi Browse this author
Nagasaka, Atsushi Browse this author
Nakanishi, Kazuaki Browse this author
Yamamoto, Yoshiya Browse this author
Nakanishi, Mitsuru Browse this author
Kohara, Toshihisa Browse this author
Sho, Takuya Browse this author
Yamamoto, Keiko Browse this author
Horimoto, Hiromasa Browse this author
Kobayashi, Tomoe Browse this author
Yokoo, Hideki Browse this author
Matsushita, Michiaki Browse this author →KAKEN DB
Todo, Satoru Browse this author
Asaka, Masahiro Browse this author
Keywords: Hepatocellular carcinoma
Hepatitis B virus
Recurrence
Antiviral therapy
Issue Date: Sep-2009
Publisher: Springer Japan
Journal Title: Journal of Gastroenterology
Volume: 44
Issue: 9
Start Page: 991
End Page: 999
Publisher DOI: 10.1007/s00535-009-0093-z
PMID: 19554391
Abstract: Background. Prediction and prevention of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) recurrence is an important clinical issue. We investigated whether HBV DNA level and antiviral therapy are associated with HCC recurrence. Methods. This retrospective study involved 103 patients who underwent hepatic resection or radiofrequency ablation for initial HCC. Patients were divided into four groups. Thirty had high serum HBV DNA levels (>4 log10 copies/mL) and had not received antiviral therapy (high virus group; HVG). Thirty-four had low HBV DNA levels (≤4 log10 copies/mL) and had not received antiviral therapy (low virus group; LVG). Twenty received antiviral therapy after HCC developed (therapeutic group A, TG-A). Nineteen received antiviral therapy before HCC developed (therapeutic group B, TG-B). Results. Cumulative HCC recurrence rates at 3 years in the HVG, LVG, TG-B, and TG-A were 71.1%, 42.2%, 42.3%, and 52.0%, respectively. Recurrence rates differed significantly between the HVG and LVG (P = 0.016) and between the HVG and TG-B (P = 0.008). Recurrence rate in the TG-A was marginally lower than in the HVG (P = 0.10). On multivariate analysis, high serum hepatitis B virus DNA levels (hazard ratio: HR, 2.67; 95% CI, 1.31-5.47; P = 0.007) and absence of antiviral therapy (HR, 2.57; 95% CI, 1.34-4.94; P = 0.005) were independent risk factors for hepatocellular carcinoma recurrence. Conclusion. HBV DNA level and antiviral therapy are associated with HCC recurrence. For patients with high HBV DNA levels, antiviral therapy before the development of HCC is important for prevention of recurrence.
Rights: The original publication is available at www.springerlink.com
Type: article (author version)
URI: http://hdl.handle.net/2115/39478
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 中馬 誠

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