Effect of the presence of hepatitis B e antigen on prognosis after liver resection for hepatocellular carcinoma in patients with chronic hepatitis B

• Published in: World journal of surgery 2002-05, Vol.26 (5), p.555-560
• Main Authors: Kubo, Shoji, Hirohashi, Kazuhiro, Yamazaki, Osamu, Matsuyama, Mitsuharu, Tanaka, Hiromu, Horii, Katsuhiko, Shuto, Taichi, Yamamoto, Takatsugu, Kawai, Shuichi, Wakasa, Kenichi, Nishiguchi, Shuhei, Kinoshita, Hiroaki
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antigens; Biological and medical sciences; Carcinoma, Hepatocellular - complications; Carcinoma, Hepatocellular - immunology; Carcinoma, Hepatocellular - surgery; Cumulative Survival Rate; Female; HBeAg Positivity; Hepatitis; Hepatitis B; Hepatitis B e antigen; Hepatitis B e Antigens - blood; Hepatitis B, Chronic - complications; Hepatitis B, Chronic - immunology; Hepatocellular carcinoma; Humans; Laboratory tests; Liver; Liver cancer; Liver Neoplasms - complications; Liver Neoplasms - immunology; Liver Neoplasms - surgery; Liver Resection; Liver, biliary tract, pancreas, portal circulation, spleen; Male; Medical prognosis; Medical sciences; Metastases; Middle Aged; Multicentric Carcinogenesis; Multivariate analysis; Neoplasm Recurrence, Local; Patients; Prognosis; Risk Factors; Severity of Illness Index; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Survival; Survival Rate; Transcatheter Arterial Embolization; Tumors
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-001-0267-1

We examineded the clinical effects of serum hepatitis B e antigen (HBeAg) positivity on clinicopathologic findings and prognosis after liver resection for hepatocellular carcinoma (HCC) in patients with chronic hepatitis B. A series of 56 patients who underwent curative resection were divided into two groups: 25 HBeAg‐positive patients (group 1) and 31 HBeAg‐negative patients (group 2). The mean age was significantly lower in group 1 than in group 2 (p=0.0021), and the proportion of patients with symptoms was significantly higher in group 1 than in group 2 (p=0.037). There were no significant differences in other clinical findings between the two groups, including laboratory test results, coexisting medical conditions, and operative methods. Although tumor size, degree of differentiation of the main tumor, and the prevalence of vascular invasion did not differ between the groups, the prevalence of intrahepatic metastasis and the proportion of patients with active hepatitis were significantly higher in group 1 than in group 2 (p=0.009 and p=0.043, respectively). Tumor‐free and cumulative survival rates were significantly lower in group 1 than in group 2 (p=0.022 and p=0.0001, respectively). Multivariate analysis of various possible risk factors demonstrated serum HBeAg positivity to be an independent risk factor for recurrence [risk ratio (RR) 2.49; 95% confidence interval (CI) 1.12–5.49; p=0.032] and an independent unfavorable factor for the survival time (RR 7.58; 95% CI 2.10–27.8; p=0.0020). We concluded that the prognosis after liver resection for HCC is worse for HBeAg‐positive patients than for HBeAg‐negative patients. Résumé Chez des patients ayant une hépatite chronique B, et une résection hépatique pour carcinome hépatocellulaire (CHC), on a cherché à connatre le retentissement clinique (basé sur les données pathocliniques et pronostique) de la positivité de l’antigène de l’hépatite Be (HBeAg) dans le sérum. Cinquante‐six patients qui ont eu une résection à visée curative ont été divisés en deux groupes: 25 patients HBeAg‐positifs (groupe 1) et 31 patients HBeAg‐négatifs (groupe 2). L’âge moyen a été significativement plus bas dans le groupe 1 que dans le groupe 2 (p=0.0021). La proportion de patients symptomatiques a été significativement plus élevée dans le groupe 1 que dans le groupe 2 (p=0.037). Il n’y avait aucune différence significative entre les deux groupes en ce qui concerne les autres données cliniques, y compris les résultats de laborat