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Nucleoside analogues lowers recurrence risk in HBV−related HCC after resection

A study in this week's issue of the Journal of the American Medical Association investigates the use of nucleoside analogues and the risk of Hepatitis B virus–related hepatocellular carcinoma recurrence following liver resection.

News image

Tumor recurrence is a major issue for patients with hepatocellular carcinoma following curative liver resection.

Dr Chun-Ying Wu and colleagues investigated the association between nucleoside analogue use and risk of tumor recurrence in patients with hepatitis B virus (HBV)−related hepatocellular carcinoma (HCC) after curative surgery.

The researchers conducted a nationwide cohort study between 2003 and 2010.

Data from the Taiwan National Health Insurance Research Database.

The 6-year overall mortalities for treated cohorts were 29%
Journal of the American Medical Association

Among 100,938 newly diagnosed hepatocellular carcinoma patients, the team identified 4569 HBV-related hepatocellular carcinoma patients who received curative liver resection for hepatocellular carcinoma between 2003 and 2010.

The team's main outcome measures included the risk of first tumor recurrence compared between patients not taking nucleoside analogues, and patients taking nucleoside analogues.

The research team found that the treated cohort had a higher prevalence of liver cirrhosis when compared with the untreated cohort, but lower risk of hepatocellular carcinoma recurrence, and lower overall death.

After adjusting for competing mortality, the treated cohort had a significantly lower 6-year hepatocellular carcinoma recurrence rate.

The team found that the 6-year overall mortalities for treated cohorts were 29%,and for untreated 42%.

The researchers observed that nucleoside analogue use, statin use, and nonsteroidal anti-inflammatory drugs or aspirin use were independently associated with a reduced risk of hepatocellular carcinoma recurrence.

The researchers verified the association in all subgroups of patients, including those who were noncirrhotic, and diabetic.

Dr Wu's team concludes, "Nucleoside analogue use was associated with a lower risk of hepatocellular carcinoma recurrence among patients with HBV-related hepatocellular carcinoma after liver resection."

JAMA 2012; 308(18): 1906-1913
15 November 2012

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