A high baseline HBV load and antiviral therapy affect the survival of patients with advanced HBV‐related HCC treated with sorafenib. (7th March 2015)

• Record Type: Journal Article
• Authors: Yang, Yu; Wen, Feng; Li, Jianliang; Zhang, Pengfei; Yan, Wenhui; Hao, Ping; Xia, Feng; Bi, Feng; Li, Qiu
• Is Part Of: Liver international. Volume 35:Number 9(2015:Sep.)
• Page Start: 2147
• Page End: 2154
• Publication Date: 2015-03-07
• Subjects: Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.12805
• Languages: English
• ISSNs: 1478-3223

Abstract

<abstract abstract-type="main" id="liv12805-abs-0001"> <title>Abstract</title> <sec id="liv12805-sec-0001" sec-type="section"> <title>Background and Aims</title> <p>Although a high viral load is an independent risk factor for recurrence of hepatitis B virus (HBV)‐related hepatocellular carcinoma (HCC) after surgery, the prognostic impact of viral load on advanced HCC is unclear. This study investigated the impact of baseline HBV load and antiviral therapy on survival of patients with advanced HCC treated with sorafenib.</p> </sec> <sec id="liv12805-sec-0002" sec-type="section"> <title>Methods</title> <p>Of 130 patients with advanced HBV‐related HCC received first‐line sorafenib therapy were evaluated in a multicenter, retrospective study.</p> </sec> <sec id="liv12805-sec-0003" sec-type="section"> <title>Results</title> <p>No patients experienced severe hepatic impairment because of HBV reactivation during sorafenib therapy. The median progression‐free survival (PFS) and overall survival (OS) of all patients were 5.7 and 9.6 months respectively. Patients with a baseline HBV DNA ≤10<sup>4</sup> copies/ml had significantly better OS than those with >10<sup>4</sup> copies/ml (10.4 vs 6.6 months; <italic>P </italic>=<italic> </italic>0.002), but PFS showed an increasing trend (5.8 vs 4.8 months; <italic>P </italic>=<italic> </italic>0.068). Patients who received antiviral therapy had a better trend in OS than those who did not (12.0 vs 8.3 months; <italic>P </italic>=<italic> </italic>0.058), but there was no difference in PFS (6.4 vs 4.1 months; <italic>P </italic>=<italic> </italic>0.280). In a multivariate analysis, the baseline HBV DNA level >10<sup>4</sup> copies/ml (<italic>P </italic>=<italic> </italic>0.001; hazard ration [HR] = 2.294; 95% CI 1.429–3.676) and antiviral therapy (<italic>P </italic>=<italic> </italic>0.038; HR 0.617; 95% CI 0.390–0.975) were independent predictors of OS.</p> </sec> <sec id="liv12805-sec-0004" sec-type="section"> <title>Conclusion</title> <p>In patients with advanced HBV‐related HCC treated with sorafenib, a high baseline HBV load was an adverse prognostic factor for survival. However, survival was significantly improved with the use of antiviral therapy.</p> </sec> </abstract>