Study of antiviral therapy on recurrence after curative resection in patients with hepatitis B virus related hepatocarcinoma

Objective To evaluate the effects of antiviral therapy in prevention of tumor recurrence after curative resection in patients with hepatitis B virus (HBV) related hepatocarcinoma. Methods The data of 78 HBV related hepatocellular carcinoma patients having underwent hepatocarcinoma curative resection were retrospectively analyzed. The patients were divided into 2 groups according to the treatment method and the serum replication level of HBV DNA: 45 patients received antiviral therapy after hepatocarcinoma curative resection (treatment group), including 28 cases of preoperative HBV DNA high replication level (HBV DNA ≥ 107 copies/L), and 17 cases of preoperative HBV DNA low replication level (HBV DNA < 107 copies/L); 33 cases only received hepatocarcinoma curative resection (control group), including 20 cases of preoperative HBV DNA high replication level, and 13 cases of preoperative HBV DNA low replication level. The median follow-up time was 11 months, and the tumor recurrence was observed. The Kaplan-Meier method was used to calculate the tumor-free survival rate, and Cox regression model was used in multi-factor prognostic analysis. Results In the follow-up period, the tumor recurrence rates in treatment group were 84.4% (38/45), in control group were 93.9% (31/33), and there was no statistical difference (P >0.05). The tumorfree survival rates at 6, 12, 18 and 24 months after operation in patients with HBV high replication level of treatment group were 78.6%, 46.4%, 32.1% and 10.7%, and in patients with HBV low replication level of treatment group were 82.4%, 64.7%, 47.1% and 35.3%; these in patients with HBV high replication level of control group were 50.0%, 15.0%, 5.0% and 0, and in patients with HBV low replication level of control group were 92.3%, 46.2%, 30.8% and 15.4%. The tumor-free survival rates in patients with HBV high replication level of control group were significantly lower than those in patients with HBV low replication level of treatment group and patients with HBV low replication level of control group, and there were statistical differences (P 0.05). Multivariate analysis result showed that preoperative serum HBV DNA ≥ 107 copies/L, lack of antiviral therapy after operation and tumor low differentiation were independent risk factors for tumor recurrence after operations (OR = 1.987, 2.119 and 2.539; P <0.05 or <0.01). Conclusions The serum HBV high replication levels and lack of antiviral therapy after operation are independent factors in influencing tumor recurrence in HBV related hepatocarcinoma patients after operation. It might be better that patients with HBV high replication level should receive an antiviral therapy as early as possible after operation. Key words: Hepatitis B virus; Hepatocellular carcinoma; Recurrence; Antiviral therapy