Effect of nucleoside analog use in patients with hepatitis B virus-related hepatocellular carcinoma

Aim To examine the effect of nucleoside analog (NA) therapy on clinical outcome in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) who underwent curative therapy. Methods A total of 131 patients with HBV-related HCC who underwent curative therapy were analyzed. They were divided into an NA group who received NA therapy (n=99, group A) and a control group (n=32, group B). Group A was further classified into two groups of patients who either received NA therapy before HCC therapy (n=34, group Aa) or who received NA therapy with initial HCC therapy (n=65, group Ab). Overall survival (OS) and recurrence-free survival (RFS) were compared in the three groups. Results The 1- and 3-year cumulative OS rates were both in group Aa, 100% and 88.0% in group Ab, and 100% and 75.7% in group B (overall significance, P=0.002), respectively. The corresponding RFS rates were 93.1% and 36.0% in group Aa, 78.3% and 45.7% in group Ab, and 78.0% and 38.0% in group B (overall significance, P=0.734), respectively. Multivariate analysis revealed that being part of group Aa (P<0.001) or group Ab (P<0.001) and having albumin levels of 4.0g/dL or more (P=0.040) were significantly associated with OS, while HCC stage (P=0.001) and hepatitis B e-antigen positivity (P<0.001) were independent predictors linked to RFS. Conclusion NA therapy in patients with HBV-related HCC may improve survival after curative therapy.