Antiviral Therapy Improves Survival After Liver Cancer Surgery

M. Alexander Otto, PA, MMS

October 20, 2022

The study covered in this summary was published on researchsquare.com as a preprint and has not yet been peer reviewed.

Key Takeaway

Why This Matters

  • HBV is a major cause of HCC.

  • There are no standard adjuvant treatments to prevent recurrence after surgery.

  • Some studies have shown that adjuvant antiviral therapy reduces the risk of recurrence and improves survival for patients with HBV-related liver cancer, but the issue hasn't been investigated in patients aged 65 years and older.

  • On the basis of their findings, the investigators recommend adjuvant antiviral therapy after curative resection of HBV-related disease in elderly patients.

Study Design

  • The team reviewed 300 patients in a Chinese liver cancer database who were aged 65 years or older when they underwent R0 resections for HCC.

  • Patients had tested positive for hepatitis B surface antigen and negative for hepatitis C antibody.

  • Overall, 177 received adjuvant antiviral therapy for more than 3 months after surgery; 123 did not.

  • Adjuvant antiviral therapies included lamivudine 100 mg/d, adefovir 10 mg/d, and entecavir 0.5 mg/d.

  • Propensity score matching was used to control bias in patient selection.

Key Results

  • After propensity score matching, the median overall survival (OS) was 5.8 years in the adjuvant antiviral therapy group and 3.9 years in the no-therapy group.

  • Median recurrence-free survival was 3.1 years with adjuvant antiviral therapy and 2.2 years without it.

  • In the adjuvant antiviral therapy group, OS at 1, 3, and 5 years was 97.5%, 76%, and 55%, respectively; without antiviral therapy, OS at 1, 3, and 5 years was 83.5%, 60.1%, and 40.9%, respectively (P for difference = .003).

  • The 1-, 3-, and 5-year recurrence-free survival rates with adjuvant antiviral therapy were 76.6%, 50.2%, and 30.4%, respectively; without antiviral therapy, the 1-, 3-, and 5-year recurrence-free survival rates were 63.2%, 42.4%, and 26.6%, respectively (P = .120).

  • Postoperative antiviral therapy protected against death on multivariate analysis (hazard ratio, 0.46; P < .001).

Limitations

  • It was a retrospective study limited to patients in China.

  • Results were not correlated with HBV genotype or use of specific antiviral therapy drugs.

Disclosures

  • The study was funded by the Medical Innovation Project of Fujian Province and others.

  • The investigators have disclosed no relevant financial relationships.

This is a summary of a preprint research study, "The Efficacy of Postoperative Antiviral Therapy in Elderly HCC Patients: A Retrospective Multicenter Propensity Score-Matched Study," led by Jinyu Zhang of the Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China, and provided to you by Medscape. The study has not been peer reviewed. The full text can be found at researchsquare.com.

M. Alexander Otto is a physician assistant with a master's degree in medical science and a journalism degree from Newhouse. He is an award-winning medical journalist who has worked for several major news outlets before joining Medscape and also an MIT Knight Science Journalism fellow. Email: aotto@mdedge.com.

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