Efficacy of antiviral therapy with nucleotide/nucleoside analogs after curative treatment for patients with hepatitis B virus-related hepatocellular carcinoma: A systematic review and meta-analysis

Background and objective: A systematic review was conducted to evaluate whether or not antiviral therapy with nucleotide/nucleoside analogs (NA) have survival benefit for patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after curative treatment. Methods: An electronic search of PubMed, EMBASE, and the Cochrane Library was performed to identify comparative studies in which the adjuvant effects of NA for patients with HBV-related HCC after curative treatment were evaluated. Primary outcome included survival rate, and secondary outcomes included tumor recurrence rate and side effects. Review Manager 5.1.6 software was used for meta-analysis. Results: Twelve studies involving 6682 patients were included in our review. Meta-analysis results demonstrated that significant differences favoring the antiviral treatment groups were observed in 1-year survival rate (RR: 0.65, 95% CI: 0.53-0.79, P < 0.0001), 3-year survival rate (RR: 0.58, 95% CI: 0.46-0.74, P < 0.0001), and 5-year survival rate (RR: 0.56, 95% CI: 0.43-0.74, P < 0.0001) compared with the control group. After NA was administered, recurrence was significantly reduced after one year (RR: 0.77, 95% CI: 0.64-0.93, P = 0.006) and three years (RR: 0.81, 95% CI: 0.71-0.93, P = 0.002) but not after five years (RR: 0.94, 95% CI: 0.76-1.16, P = 0.55) compared with non-NA therapy. Conclusion: Current evidence showed that antiviral therapy with NA could improve survival and reduce early recurrence for patients with HBV-related HCC after curative treatment. More high quality prospective trials are expected. (C) 2015 Elsevier Masson SAS. All rights reserved.