HBV is a risk factor for poor patient prognosis after curative resection of hepatocellular carcinoma: A retrospective case–control study

• Published in: Medicine (Baltimore) 2016-08, Vol.95 (31), p.e4224-e4224
• Main Authors: Li, Zhonghu, Zhao, Xin, Jiang, Peng, Xiao, Senlin, Wu, Guo, Chen, Kai, Zhang, Xi, Liu, Hui, Han, Xiuguo, Wang, Shuguang, Li, Xiaowu
• Format: Article
• Language: English
• Subjects: Adult; Aged; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - surgery; Carcinoma, Hepatocellular - virology; Case-Control Studies; China; Disease-Free Survival; DNA, Viral - analysis; Female; Follow-Up Studies; Hepatectomy - methods; Hepatectomy - mortality; Hepatitis B - complications; Hepatitis B - diagnosis; Hepatitis B virus - isolation & purification; Hepatitis C - complications; Hepatitis C - diagnosis; Humans; Kaplan-Meier Estimate; Liver Function Tests; Liver Neoplasms - mortality; Liver Neoplasms - pathology; Liver Neoplasms - surgery; Liver Neoplasms - virology; Male; Middle Aged; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - pathology; Observational Study; Proportional Hazards Models; Retrospective Studies; Risk Assessment; Survival Analysis; Treatment Outcome
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000004224

Controversy exists regarding pathological factors affecting the prognosis of hepatocellular carcinoma (HCC) patients with hepatitis B virus (HBV-HCC). Their postoperative clinical behaviors and the exact HBV Deoxyribonucleic Acid (DNA) thresholds that distinguish good and poor prognoses are unknown. This study aimed to compare clinicopathological, pre- and postoperative clinical factors and overall and recurrence-free survival (RFS) between HBV-HCC patients and nonhepatitis B and nonhepatitis C HCC (NBC-HCC) patients to determine the optimal prognostic HBV DNA threshold.Data from 1440 patients with HBV-HCC and NBC-HCC who underwent curative hepatectomy were retrospectively analyzed.Liver function in the HBV-HCC group was significantly worse than in the NBC-HCC group. Compared with NBC-HCC patients, HBV-HCC patients had significantly more vascular invasion and advanced HCC. The HBV-HCC patients also had significantly worse liver function and more complications. Further survival analysis showed significantly lower overall and RFS rates and a higher early recurrence rate in the HBV-HCC group. Univariate analysis indicated that HBV was a risk factor for overall and RFS. Finally, X-tile analysis revealed that the optimal HBV DNA cutoff points for predicting RFS and overall survival in HCC patients were 10,100 and 12,800 IU/mL, respectively.After hepatectomy for HCC, HBV-HCC patients had more complications and a worse prognosis than NBC-HCC patients. Antiviral therapy should be considered before hepatectomy in patients with high (more than approximately 10 IU/mL) HBV DNA levels.