Clinical Research Papers:
Randomized clinical trial: Nucleos(t)ide analogues improved survival of CHB-related HCC patients via reducing severity and progression of malignancy
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Abstract
Yun Wang1,*, Xiaogang Xiang1,*, Liwen Chen1, Zhujun Cao1, Rebecca Bao2, Huijuan Zhou1, Weiliang Tang1, Jie Lu1, Lanyi Lin1, Qing Xie1, Shisan Bao3, Hui Wang1
1Department of Infectious Diseases and Hepatology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
2Discipline of Anatomy and Histology F13, The University of Sydney, New South Wales, Australia
3Discipline of Pathology, School of Medical Sciences and Bosch Institute, The University of Sydney, New South Wales, Australia
*These authors contributed equally to this work
Correspondence to:
Hui Wang, email: [email protected]
Shisan Bao, email: [email protected]
Keywords: nucleos(t)ide analogues, survival, chronic hepatitis B, hepatocellular carcinoma
Received: April 21, 2016 Accepted: June 06, 2016 Published: June 18, 2016
ABSTRACT
Background: The influence of nucleos(t)ide analogues (NAs) to treat Chronic hepatitis B (CHB) related hepatocellular carcinoma (HCC) remains to be explored.
Aim: To investigate if NAs reduce the severity and progression of CHB-related HCC.
Results: Among 532 patients, there were 118 or 414 CHB-related HCC with or without NAs therapy, respectively. BCLC scores, serum level of ALT/AST and HBV DNA were compared. During follow-up, the survival period of CHB-related HCC patients with sustained NAs is significantly longer than that with NAs post-HCC and NAs naïve (p < 0.05). Factors significantly associated with the poor overall survival of CHB-related HCC include BCLC scores (hazard ratio, 1.84 [95% confidence interval, 1.57−2.15], p < 0.001), NAs post-HCC or NAs naïve (1.33 [1.07−1.65], p < 0.01), serum AST ≥ 40 IU/L (1.48 [1.03−2.12], p < 0.05) and HBV DNA ≥ 104 copies/ml (1.36 [1.01−1.83], p < 0.001).
Methods: Outcomes of 532 CHB-related HCC patients with/without NAs were investigated. Overall survival of CHB-related HCC patients, NAs naïve (n = 156), NAs received post-HCC (n = 258) and NAs sustained (n = 118) were determined.
Conclusions: NAs reduced severity of CHB-related HCC patients. Sustained NAs is an important factor associated with the extended survival of CHB-related HCC patients.
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