Dataset Information

Safety and efficacy of lamivudine after radiofrequency ablation in patients with hepatitis B virus-related hepatocellular carcinoma.

ABSTRACT: BACKGROUND: Antiviral treatments for hepatitis B virus (HBV) are not established in patients with HBV-related hepatocellular carcinoma (HCC). AIM: To investigate the safety and efficacy of lamivudine (LAM) in patients with HBV-related HCC who were treated with radiofrequency ablation (RFA). METHODS: RFA-treated patients with HBV-related HCC were retrospectively divided into those who received LAM (LAM group) and those who did not (nontreatment group). The first-year changes in serum alanine aminotransferase (ALT), total bilirubin (TBIL), and albumin (ALB) levels were compared in corresponding subsets based on Child-Pugh classification (Mann-Whitney U test) and between one-to-one matched pairs (Wilcoxon signed rank test), who were selected on the basis of their propensity scores for receiving LAM. Overall and recurrence-free survival was also compared. RESULTS: Complete ablation of HCC was achieved in 104 patients with HBV-related HCC between January 2000 and December 2005. LAM was administered to 33 patients after RFA. Serum HBV-DNA became negative by TMA method in 24 (73%) patients. Four patients showed redetection of HBV-DNA with ALT elevation. Subset analysis based on initial Child-Pugh class and paired analysis with matching revealed significant decreases in ALT and bilirubin levels and increases in ALB levels in the first year in the LAM group (DeltaALT = -17, DeltaALB = +0.3, and DeltaTBIL = -0.2) compared with controls (DeltaALT = +5, DeltaALB = +/-0.0, and DeltaTBIL = +0.3). Overall survival and recurrence-free survival did not differ between the two groups. No specific adverse effect was observed in the LAM group. CONCLUSION: LAM after RFA for HBV-related HCC was safe and improved liver function. Further studies are needed to evaluate its effect on survival.

SUBMITTER: Yoshida H

PROVIDER: S-EPMC2716870 | biostudies-other | 2008 Mar

REPOSITORIES: biostudies-other

ACCESS DATA

Similar Datasets

Project description:It remains controversial whether surgical resection, compared to radiofrequency ablation (RFA), improves overall survival (OS) in patients with early hepatocellular carcinoma (HCC). This study aimed to compare OS after RFA with that after resection for HCC. This retrospective study included patients who underwent RFA or surgical resection as initial treatment for hepatitis B virus (HBV)-related HCC at a very early or early stage. A total of 761 patients (RFA, n = 194; resection, n = 567) from Seoul National University Hospital (Seoul, South Korea) and 1277 patients (RFA, n = 352; resection, n = 925) from the Korean Primary Liver Cancer Registry were included in the hospital and nationwide cohorts, respectively. Primary and secondary endpoints were OS and recurrence-free survival (RFS), respectively. Additional analysis was performed when the history of the antiviral treatment and the type of prescribed nucleos(t)ide analogue were confirmed. The rate of complications was compared between the two treatment groups in the hospital cohort. Baseline characteristics were balanced, using inverse probability of treatment weighting (IPTW). In the hospital cohort, the RFA group had a smaller mean tumor size (1.7 vs. 3.9 cm) but a higher proportion of cirrhotic patients than the resection group (85.6% vs. 63.1%) (both p < 0.01). During 81.0 (interquartile range, 62.3-107.1) months of follow-up, there was no difference in OS (adjusted hazard ratio (aHR) = 0.870, 95% confidence interval (CI) = 0.400-1.897, p = 0.73) and RFA was associated with shorter RFS (aHR = 1.562, 95% CI = 1.099-2.219, p = 0.01) after employing IPTW. Antiviral treatment was independently associated with longer OS (aHR = 0.444, 95% CI = 0.251-0.786, p = 0.01) as well as RFS (aHR = 0.544, 95% CI = 0.391-0.757, p < 0.01) in the hospital cohort. In the nationwide cohort, there was no difference in OS (aHR = 0.981, 95% CI = 0.661-1.456, p = 0.92) between the two treatment groups when adjusted for antiviral treatment, which was a negative independent risk factor for mortality (aHR = 0.655, 95% CI = 0.451-0.952, p = 0.03) after IPTW. Among patients treated with tenofovir (n = 96) or entecavir (n = 184) in the hospital cohort, there was no difference in either OS (aHR = 0.522, 95% CI = 0.058-4.724, p = 0.56) or RFS (aHR = 1.116, 95% CI = 0.738-1.688, p = 0.60). The overall incidence of complications was higher in the resection group (26.3%) than in the RFA group (13.9%) (p < 0.01). RFA may provide comparable OS to resection in the treatment of very early or early HCC with a lower rate of complications, although RFS is marginally shorter than in the resection group after adjusting for antiviral treatment. Regardless of the type of NA, antiviral treatment in patients with HBV-related HCC is strongly associated with both OS and RFS.

Dataset Information

Safety and efficacy of lamivudine after radiofrequency ablation in patients with hepatitis B virus-related hepatocellular carcinoma.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets