The effect of nucleos(t)ide analogues on clinical outcomes of patients treated with transarterial chemoembolization and radiofrequency ablation for hepatitis B virus-related hepatocellular carcinoma

• Published in: Journal of liver cancer Vol. 21; no. 2; pp. 155 - 162
• Main Authors: Park, Jae Min, Choe, Won Hyeok, Kim, Jeong Han, Kwon, So Young, Yoo, Byung Chul
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Liver Cancer Association 01.09.2021; 대한간암학회
• Subjects: hepatitis b; hepatocellular carcinoma; nucleos(t)ide analogues; Original; radiofrequency ablation; transarterial chemoembolization; 의학일반; Radiofrequency ablation; Hepatocellular carcinoma; Nucleos(t)ide analogues; Transarterial chemoembolization; Hepatitis B
• ISSN: 2288-8128; 2383-5001; 2383-5001
• DOI: 10.17998/jlc.2021.09.22

Background/Aims: Because hepatitis B virus (HBV) replication has been known to play animportant role in cancer recurrence after curative treatment of HBV-related hepatocellularcarcinoma (HCC), we examined whether treatment based on nucleos(t)ide analogues (NAs)might decrease the recurrence rate and improve patient survival.Methods: The retrospective cohort study enrolled 73 patients with chronic hepatitis B whowere treated with transarterial chemoembolization (TACE) and radiofrequency ablation (RFA)with curative intent for HCC. Among those, 30 and 43 patients were treated with tenofovirdisoproxil fumarate (TDF) and entecavir (ETV), respectively.Results: Of the 73 patients, 51 experienced HCC recurrence, and 14 patients were deadduring a follow-up of 73±34 months. Multivariate analyses showed that tumor size (hazardratio [HR], 1.590; 95% confidence-interval [CI], 1.106-2.285; P=0.012) and Child-Pugh class B(vs. class A/non cirrhosis; HR, 5.794; 95% CI, 2.311-14.523; P=0.001) was significantly associatedwith HCC recurrence, and Child-Pugh class B (HR, 7.357; 95% CI, 2.100-25.777; P=0.002) was anindependent unfavorable prognostic factor for survival. During NAs therapy, TDF was superiorto ETV for complete viral response at 1 year after the date of combination of TACE and RFA(P=0.016). However, the risks of HCC recurrence and survival were not significantly differentbetween those treated with TDF versus ETV.Conclusions: TDF was superior to ETV for achieving complete viral response. However, therecurrence and mortality after TACE and RFA for HBV-related HCC were not significantlydifferent between patients treated with TDF versus ETV.