Negative hepatitis B envelope antigen predicts intrahepatic recurrence in hepatitis B virus-related hepatocellular carcinoma after ablation therapy

[Guest guest]

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

Negative hepatitis B envelope antigen predicts intrahepatic recurrence in

hepatitis B virus-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 Lee3

Article first published online: 20 OCT 2011

DOI: 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

Volume 26, Issue 11, pages 1638–1645, November 2011

Abstract

Background and Aim:  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 years) were

included. Ninety patients (62.1%) had serum HBV DNA ≥ 2000 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.

[Guest guest]

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

Negative hepatitis B envelope antigen predicts intrahepatic recurrence in

hepatitis B virus-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 Lee3

Article first published online: 20 OCT 2011

DOI: 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

Volume 26, Issue 11, pages 1638–1645, November 2011

Abstract

Background and Aim:  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 years) were

included. Ninety patients (62.1%) had serum HBV DNA ≥ 2000 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.