Lamivudine versus Entecavir for Newly Diagnosed Hepatitis B Virus-Related Hepatocellular Carcinoma
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Background/Aims: Antiviral therapy is a key component in the management of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) patients. However, whether the potent drug entecavir is more effective than a less potent drug, such as lamivudine, in HBV-related HCC is not clear. Methods: A retrospective cohort of 451 newly diagnosed, HBV-related HCC patients without antiviral therapy at diagnosis, who started antiviral therapy with either entecavir (n=249) or lamivudine (n=202), were enrolled. Results: The median survival was longer for the entecavir group than for the lamivudine group, and lamivudine use (vs entecavir) was an independent factor for mortality (hazard ratio [HR], 1.49; p=0.002). Lamivudine use (vs entecavir) was an independent risk factor for new-onset hepatic decompensation (HR, 1.67; p=0.010) in 318 patients without previous hepatic decompensation, and it was also an independent risk factor for recurrence after curative therapy (HR, 1.84; p=0.002) in 117 patients who received curative therapy. The findings were similar in a propensity score-matched cohort. Conclusions: Overall survival, decompensation-free survival, and recurrence-free survival were better in the entecavir-treated patients than in the lamivudine treated-patients, indicating that the potent antiviral drug should be the preferred choice in HBV-related HCC patients.
Abstract
Background/Aims: Antiviral therapy is a key component in the management of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) patients. However, whether the potent drug entecavir is more effective than a less potent drug, such as lamivudine, in HBV-related HCC is not clear. Methods: A retrospective cohort of 451 newly diagnosed, HBV-related HCC patients without antiviral therapy at diagnosis, who started antiviral therapy with either entecavir (n=249) or lamivudine (n=202), were enrolled. Results: The median survival was longer for the entecavir group than for the lamivudine group, and lamivudine use (vs entecavir) was an independent factor for mortality (hazard ratio [HR], 1.49; p=0.002). Lamivudine use (vs entecavir) was an independent risk factor for new-onset hepatic decompensation (HR, 1.67; p=0.010) in 318 patients without previous hepatic decompensation, and it was also an independent risk factor for recurrence after curative therapy (HR, 1.84; p=0.002) in 117 patients who received curative therapy. The findings were similar in a propensity score-matched cohort. Conclusions: Overall survival, decompensation-free survival, and recurrence-free survival were better in the entecavir-treated patients than in the lamivudine treated-patients, indicating that the potent antiviral drug should be the preferred choice in HBV-related HCC patients.
참고문헌 (30)
- Beasley RP, "Hepatitis B virus. The major etiology of hepatocellular carcinoma", Cancer, 61, pp.1942~1956 (1988)
- Perz JF, "The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide", J Hepatol, 45, pp.529~538 (2006)
- Yang JD, "Hepatocellular carcinoma: a global view", Nat Rev Gastroenterol Hepatol, 7, pp.448~458 (2010)
- Trépo C, "Hepatitis B virus infection", Lancet, 384, pp.2053~2063 (2014)
- Fontana RJ, "Side effects of long-term oral antiviral therapy for hepatitis B", Hepatology, 49(5), pp.S185~S195 (2009)
- Yam JC, "Predictive factors affecting the short term and long term exodrift in patients with intermittent exotropia after bilateral rectus muscle recession and its effect on surgical outcome", Biomed Res Int, 2014, pp.482093~ (2014)
- Liaw YF, "Lamivudine for patients with chronic hepatitis B and advanced liver disease", N Engl J Med, 351, pp.1521~1531 (2004)
- Wu CY, "Association of nucleos(t)ide analogue therapy with reduced risk of hepatocellular carcinoma in patients with chronic hepatitis B: a nationwide cohort study", Gastroenterology, 147(e5), pp.143~151 (2014)
- Wu CY, "Association between nucleoside analogues and risk of hepatitis B virus-related hepatocellular carcinoma recurrence following liver resection", JAMA, 308, pp.1906~1914 (2012)
- Sun P, "Nucleot(s)ide analogues for hepatitis B virus-related hepatocellular carcinoma after curative treatment: a systematic review and meta-analysis", PLoS One, 9, pp.e102761~ (2014)
- Sohn W, "HBV DNA and HBsAg levels as risk predictors of early and late recurrence after curative resection of HBV-related hepatocellular carcinoma", Ann Surg Oncol, 21, pp.2429~2435 (2014)
- Sohn W, "Sorafenib therapy for hepatocellular carcinoma with extrahepatic spread: treatment outcome and prognostic factors", J Hepatol, 62, pp.1112~1121 (2015)
- Huang G, "Antiviral therapy improves postoperative survival in patients with hepatocellular carcinoma: a randomized controlled trial", Ann Surg, 261, pp.56~66 (2015)
- Hann HW, "A long-term study of the effects of antiviral therapy on survival of patients with HBVassociated hepatocellular carcinoma (HCC) following local tumor ablation", Cancer Med, 3, pp.390~396 (2014)
- European Association for the Study of the Liver, "EASL clinical practice guidelines: management of chronic hepatitis B virus infection", J Hepatol, 57, pp.167~185 (2012)
- Korean Association for the Study of the Liver, "KASL clinical practice guidelines: management of chronic hepatitis B", Clin Mol Hepatol, 18, pp.109~162 (2012)
- Lok AS, "Chronic hepatitis B: update 2009", Hepatology, 50, pp.661~662 (2009)
- Yapali S, "Potential benefit of telbivudine on renal function does not outweigh its high rate of antiviral drug resistance and other adverse effects", Gastroenterology, 146, pp.15~19 (2014)
- Chang TT, "A comparison of entecavir and lamivudine for HBeAg-positive chronic hepatitis B", N Engl J Med, 354, pp.1001~1010 (2006)
- Lai CL, "Entecavir versus lamivudine for patients with HBeAg-negative chronic hepatitis B", N Engl J Med, 354, pp.1011~1020 (2006)
- Lim YS, "Mortality, liver transplantation, and hepatocellular carcinoma among patients with chronic hepatitis B treated with entecavir vs lamivudine", Gastroenterology, 147, pp.152~161 (2014)
- "Guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection" (2015)[URL]
- Xu X, "Role of lamivudine with transarterial chemoembolization in the survival of patients with hepatocellular carcinoma", J Gastroenterol Hepatol, 29, pp.1273~1278 (2014)
- Yin J, "Effect of antiviral treatment with nucleotide", nucleoside analogs on postoperative prognosis of hepatitis B virus-related hepatocellular carcinoma: a two-stage longitudinal clinical study, 2013, pp.31, 3647~3655
- Kuzuya T, "Efficacy of antiviral therapy with lamivudine after initial treatment for hepatitis B virus-related hepatocellular carcinoma", J Gastroenterol Hepatol, 22, pp.1929~1935 (2007)
- Kim YW, "Short term virologic efficacies of telbivudine versus entecavir against hepatitis B-related hepatocellular carcinoma", Gastroenterol Res Pract, 2015, pp.181065~ (2015)
- Shin HS, "Antiviral efficacy of lamivudine versus entecavir in patients with hepatitis B virus-related advanced hepatocellular carcinoma", J Gastroenterol Hepatol, 27, pp.1528~1534 (2012)
- Korean Liver Cancer Study Group, "Practice guidelines for management of hepatocellular carcinoma 2009", Korean J Hepatol, 15, pp.391~423 (2009)
- Yu SJ, "Hepatitis B viral load affects prognosis of hepatocellular carcinoma", World J Gastroenterol, 20, pp.12039~12044 (2014)
- Jin YJ, "Suppressive effects of entecavir on hepatitis B virus and hepatocellular carcinoma", J Gastroenterol Hepatol, 26, pp.1380~1388 (2011)