Negative Hepatitis B envelop Antigen predicts intrahepatic recurrence in HBV-related hepatocellular carcinoma after ablation therapy

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http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1746.2011.06777.x/abstract

Negative Hepatitis B envelop Antigen predicts intrahepatic recurrence in

HBV-related hepatocellular carcinoma after ablation therapy

Goh Eun Chung1,3, Won Kim2,3,*, Jeong-Hoon Lee3, Yoon Jun Kim3, Jung-Hwan Yoon3,

Jeong Min Lee4, Jae Young Lee4, Se Hyung Kim4, Donghee Kim1, Hyo-Suk Lee3DOI:

10.1111/j.1440-1746.2011.06777.x

© 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell

Publishing Asia Pty Ltd

Issue

Journal of Gastroenterology and Hepatology

Accepted Article (Accepted, unedited articles published online for future

issues)

*Correspondence: Won Kim, MD, PhD Department of Internal Medicine, Seoul

Metropolitan Government Seoul National University Boramae Medical Center 39,

Boramae Road, Dongjakgu, Seoul, Korea, 156-707 E-mail: drwon1@... Tel:

82-2-870-2233 Fax: 82-2-870-1476

Source of support This research was supported by the 2006 Korean Association for

the study of the Liver Research Fund. Clinical trial registered with

www.clinicaltrials.gov (NCT 00397540). This article was presented as a poster at

the 61th Annual Meeting of the American Association for the Study of Liver

Diseases (AASLD) in Boston, October 29-November 2, 2010.

No Conflict of Interest

This is an Accepted Article that has been peer-reviewed and approved for

publication in the Journal of Gastroenterology and Hepatology, but has yet to

undergo copy-editing and proof correction. Please cite this article as an

“Accepted Articleâ€; doi: 10.1111/j.1440-1746.2011.06777.x

Publication History

Accepted manuscript online: 18 MAY 2011 07:01AM EST

Received date: 26-Jan-2011 , Accepted date: 4-May-2011

Abstract

Backgrounds/Aims: Patients with persistently active hepatitis B virus (HBV)

replication are at high risk for progression to liver cirrhosis and

hepatocellular carcinoma (HCC). The influence of the viral load of HBV on

intrahepatic recurrence after local ablation therapy in patients with

HBV-related HCC has not been elucidated. We aimed to evaluate predictors of

intrahepatic recurrence and clarify the correlation between viral load and

intrahepatic recurrence after percutaneous ablation.

Methods: Patients with HBV-related, solitary HCC undergoing radiofrequency

ablation (RFA) or percutaneous ethanol injection (PEI), between October 2004 and

December 2008 were prospectively enrolled. Statistical analyses were performed

using the Kaplan-Meier method and regression model to identify risk factors

for intrahepatic recurrence.

Results: A total of 145 patients (male, 81.4%; mean age, 55.3 yr) were included.

Ninety patients (62.1%) had serum HBV DNA ≥2,000 IU/mL. The median follow-up

duration was 28.9 months (range, 12.0–57.0) and 63 patients (43.4%)

experienced intrahepatic tumor recurrence. Multivariate analysis indicated that

seropositivity for hepatitis B envelope antigen (HBeAg) was an independent

negative predictor of intrahepatic recurrence (hazard ratio, 0.473; P= 0.026)

and late (≥1 year) recurrence (HR, 0.288; P= 0.012). The serum

alpha-fetoprotein (AFP) level also significantly predicted late recurrence (HR,

1.001; P= 0.005). However, neither the ablation method nor serum HBV DNA titers

were correlated with intrahepatic recurrence.

Conclusions: These findings show that HBeAg-negativity and serum AFP levels were

associated with late intrahepatic recurrence of HCC, implicating

HBeAg-negativity as a risk factor for de novo recurrence after percutaneous

ablation in HBV-related HCC.