Meta-analysis: the efficacy of anti-viral therapy in prevention of recurrence after curative treatment of chronic hepatitis B-related hepatocellular carcinoma

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http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2011.04634.x/abstract

Meta-analysis: the efficacy of anti-viral therapy in prevention of recurrence

after curative treatment of chronic hepatitis B-related hepatocellular carcinoma

J. S.-W. Wong1, G. L.-H. Wong2,3, K. K.-F. Tsoi2,3, V. W.-S. Wong2,3, S. Y.-S.

Cheung1, C.-N. Chong1, J. Wong1, K.-F. Lee1, P. B.-S. Lai1,2, H. L.-Y.

Chan2,3Article first published online: 24 MAR 2011

DOI: 10.1111/j.1365-2036.2011.04634.x

© 2011 Blackwell Publishing Ltd

Issue

Alimentary Pharmacology & Therapeutics

Early View (Articles online in advance of print)

Summary

Background  The role of anti-viral therapy in prevention of hepatocellular

carcinoma (HCC) recurrence is to be defined.

Aim  To investigate the role of anti-viral therapy in prevention of tumour

recurrence after curative treatment of hepatitis B virus (HBV)-related HCC.

Methods  A systematic electronic search on keywords including HCC and

different anti-viral therapies was performed through eight electronic databases,

including Medline, EMBASE and Cochrane Databases. The primary outcome was HCC

recurrence after curative treatment of HBV-related HCC. The secondary outcomes

were mortality related to HCC, mortality related to liver failure and the

overall mortality.

Results  Nine cohort studies were included with a total number of 551

patients: 204 patients with anti-viral treatment group and 347 patients without

anti-viral treatment (control group). There was significant difference in the

incidence of HCC recurrence in favour of the anti-viral treatment group (55% vs.

58%; odds risk (OR) = 0.59, 95% CI 0.35–0.97, P = 0.04). The risk of HCC was

reduced by 41% in the anti-viral treatment group. There were also significant

differences in favour of anti-viral treatment group in terms of liver-related

mortality (0% vs. 8%; OR = 0.13, 95% CI 0.02–0.69, P = 0.02) and overall

mortality (38% vs. 42%; OR = 0.27, 95% CI 0.14–0.50, P < 0.001).

Conclusions  Anti-viral therapy has potential beneficial effects after the

curative treatment of HBV-related hepatocellular carcinoma in terms of tumour

recurrence, liver-related mortality and overall survival. Anti-viral therapy

should be considered after curative treatment of hepatocellular carcinoma.