Trajectories of postoperative hepatitis B virus (HBV) DNA and HBV-related hepatocellular carcinoma outcomes

Yan-Jun Xiang ¹, Kang Wang ², Ying-Yi Qin ³

¹Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China; Department of Hepatobiliary Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
²Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China.
³Department of Health Statistics, Naval Medical University, Shanghai, China.
⁴Department of Hepatobiliary Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
⁵Department of Gastrointestinal Surgery, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
⁶Department of Hepatobiliary Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
⁷Department of Hepatobiliary Surgery, General Hospital of Northern Theater Command, Shenyang, China.
⁸Department of Hepatobiliary Surgery, Affiliated Hospital of Binzhou Medical College, Binzhou, China.
⁹Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
¹⁰The First Hospital of Jiaxing Affiliated Hospital of Jiaxing University, Jiaxing, China.
¹¹Department of Hepatology, The Sixth People's Hospital of Shenyang, Shenyang, China.
¹²CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China.

⁰Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China; Department of Hepatobiliary Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.

European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology +

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November 30, 2024

View abstract on PubMed

Summary

Hepatitis B virus (HBV) DNA trajectories after liver resection impact survival in hepatocellular carcinoma (HCC) patients. Monitoring HBV DNA changes alongside antiviral therapy is crucial for improving outcomes.

Area Of Science

Hepatology
Oncology
Virology

Background

Preoperative Hepatitis B virus (HBV) DNA levels correlate with prognosis in HBV-associated hepatocellular carcinoma (HCC) post-liver resection.
Dynamic changes in HBV DNA levels after resection have not been previously reported.
Understanding these dynamics is key for optimizing patient management.

Purpose Of The Study

To describe the trajectory of HBV DNA levels after R0 liver resection in patients with HBV-related HCC undergoing antiviral therapy.
To investigate the impact of these dynamic HBV DNA changes on clinical outcomes, specifically overall survival (OS).

Main Methods

A longitudinal, multicenter, retrospective observational study included 684 patients with HBV-related HCC who underwent R0 hepatectomy and antiviral therapy.
Latent class growth mixed modeling (LCGMM) was used to identify distinct HBV DNA change trajectories.
Multifactorial COX regression analyzed independent risk factors for OS.

Main Results

Five distinct HBV DNA trajectories were identified using LCGMM.
Patients were reclassified into three groups based on survival: slow decline, slow zeroing, and fast zeroing, with 5-year OS rates of 34.5%, 53.0%, and 70.9%, respectively.
HBV DNA trajectory groups, ALBI grade, HBV reactivation, cirrhosis, tumor diameter, and microvascular invasion were independent risk factors for OS.

Conclusions

HBV DNA trajectories post-R0 liver resection are significantly associated with overall survival in patients with HBV-related HCC.
Regular monitoring of HBV DNA and continued antiviral therapy are essential for managing these patients.

Keywords:

Antiviral Cancer Liver resection Surgery Virological response nucleos(t)ide analogs