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Published on: September 25, 2019
Preoperative HBsAg seroclearance affects long-term outcomes for hepatitis B virus-related hepatocellular carcinoma
Si-Yu Liu1, Lin Zhu2, Wen-Feng Lu3
1Department of Laboratory Medicine, The Key Laboratory of Imaging Diagnosis and Minimally Invasive Interventional Research of Zhejiang Province, The Fifth Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
Background & Aims:
We aimed to investigate the impact of HBsAg seroclearance on the long-term prognosis of HBV-related HCC following curative liver resection.
Methods:
Patients treated with curative-intent hepatectomy for HBV-related HCC in 4 Chinese hospitals were enrolled. Patients were stratified into HBsAg-positive and HBsAg-seroclearance groups. Overall survival (OS) and time-to-recurrence (TTR) were compared between HBsAg-positive and HBsAg-seroclearance patients using propensity score matching (PSM). Independent risk factors of OS, cancer-specific survival (CCS) and TTR were identified by univariable and multivariable Cox regression and competing risk regression analyses.
Results:
Among 1008 HBV-related HCC patients, 81 (8.0%) patients achieved HBsAg seroclearance before surgery. Patients in HBsAg-seroclearance groups had better liver function reserve. Postoperative morbidity was comparable between the two groups before and after PSM. In the entire cohort, the Kaplan-Meier curves showed that HBsAg-seroclearance patients had better OS (p = 0.022) and TTR (p < 0.001). However, there was no significant difference between the two groups of patients regarding OS (p = 0.134) in the PSM cohort. Multivariable Cox regression and competing risk regression analyses demonstrated that HBsAg seroclearance was independently associated with lower TTR (p < 0.05), but not with better OS and CSS (p > 0.05).
Conclusions:
Preoperative HBsAg seroclearance is associated with a lower risk of TTR for HBV-related HCC among patients undergoing curative hepatectomy.
