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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概要
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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.
- 2009-09-01
著者
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TODO Satoru
Department of First Surgery, Hokkaido University Graduate School of Medicine
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Hige Shuhei
Department Of Gastroenterology And Hematology Hokkaido University
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Hige Shuhei
北海道大学病院 光学医療診療部
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Hige Shuhei
Department Of Gastroenterology And Hematology Hokkaido University Graduate School Of Medicine
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Asaka Masahiro
Department Of Gastroenterology And Hematology Hokkaido University Graduate School Of Medicine
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CHUMA MAKOTO
Department of Gastroenterology, Hokkaido University Graduate School of Medicine
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Todo Satoru
First Department Of Surgery Hokkaido University Hospital
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Todo Satoru
Department Of First Surgery Hokkaido University Graduate School Of Medicine
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Todo Satoru
University Of Pittsburgh
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Todo Satoru
Department Of First Department Of Surgery Hokkaido University Graduate School Of Medicine
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Asaka Masahiro
Third Department Of Internal Medicine Hokkaido University Graduate School Of Medicine
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Meguro Takashi
Department of Pediatrics, St. Marianna University, School of Medicine
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Yamamoto Keiko
Department Of Geophysics Graduate School Of Science Kyoto University Kyoto Japan
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Meguro Takashi
Department Of Internal Medicine Hokkaido Gastroenterology Hospital
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Maruta Ichiroh
Department Of Hematology And Oncology Hokkaido University Graduate School Of Medicine
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KAMIYAMA Toshiya
Department of General Surgery, Hokkaido University
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NAGASAKA Atsushi
Department of Gastroenterology, Sapporo Municipal Hospital
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NAKANISHI Kazuaki
Department of General Surgery, Hokkaido University
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YAMAMOTO Yoshiya
Department of Gastroenterology, Hakodate Municipal Hospital
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NAKANISHI Mitsuru
Department of Gastroenterology and Hematology, Hokkaido University
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KOHARA Toshihisa
Department of Gastroenterology and Hematology, Hokkaido University
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SHO Takuya
Department of Gastroenterology and Hematology, Hokkaido University
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HORIMOTO Hiromasa
Department of Gastroenterology and Hematology, Hokkaido University
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KOBAYASHI Tomoe
Department of Gastroenterology and Hematology, Hokkaido University
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YOKOO Hideki
Department of General Surgery, Hokkaido University
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MATSUSHITA Michiaki
Department of General Surgery, Hokkaido University
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Imamura Masahiro
Department Of Internal Medicine Saiseikai-hita Hospital
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Yamashita Kenichiro
Department Of Gastroenterology And Hematology Hokkaido University
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Chuma Makoto
Hokkaido Univ. Sapporo Jpn
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Chuma Makoto
Department Of Gastroenterology And Hematology Hokkaido University
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Sho Takuya
Department Of Gastroenterology And Hematology Hokkaido University
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Todo S
Department Of General Surgery Hokkaido University
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Todo Satoru
Department Of Pediatric Surgery First Surgery Endoscopy And Pathology Hokkaido University School Of
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Asaka Masahiro
Hokkaido Univ. School Of Medicine Sapporo Jpn
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Todo Satoru
Division Of Cardiovascular Surgery Jichi Medical University
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Nakanishi Kazuaki
Department Of Biology Faculty Of Science Kumamoto University
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Matsushita Michiaki
Department Of Digestive And General Surgery Hokkaido University Graduate School Of Medicine
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Yokoo Hideki
Department Of Digestive And General Surgery Hokkaido University Graduate School Of Medicine
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Nagasaka Atsushi
Department Of Gastroenterology Sapporo Municipal Hospital
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Nagasaka Atsushi
Department Of Biological Mechanisms And Functions Graduate School Of Bioagricultural Sciences Nagoya
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Kamiyama Toshiya
Department Of Digestive And General Surgery Hokkaido University Graduate School Of Medicine
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Nishikawa K
Department Of Digestive And General Surgery Hokkaido University Graduate School Of Medicine
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Yamamoto Keiko
Department Of Basic Allied Medicine School Of Health Sciences Gunma University
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Nakanishi Kazuaki
First Department Of Surgery Hokkaido University School Of Medicine
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Asaka M
Department Of Gastroenterology Hokkaido University Graduate School Of Medicine
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Meguro Takashi
Department Of General Surgery Graduate School Of Medicine Hokkaido University
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Kamiyama Toshiya
Department Of First Surgery Hokkaido University Graduate School Of Medicine
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Asaka Masahiro
Department Of Cancer Preventive Medicine Graduate School Of Medicine Hokkaido University
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