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The efficacies of entecavir and tenofovir in terms of enhancing prognosis after curative treatment of hepatitis B virus–related hepatocellular carcinoma

  • Author Footnotes
    1 Ji Hyun Lee and Beom Kyung Kim equally contributed to this work
    Ji Hyun Lee
    Footnotes
    1 Ji Hyun Lee and Beom Kyung Kim equally contributed to this work
    Affiliations
    Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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  • Author Footnotes
    1 Ji Hyun Lee and Beom Kyung Kim equally contributed to this work
    Beom Kyung Kim
    Footnotes
    1 Ji Hyun Lee and Beom Kyung Kim equally contributed to this work
    Affiliations
    Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea

    Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea

    Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea
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  • Soo Young Park
    Affiliations
    Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea
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  • Won Young Tak
    Affiliations
    Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea
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  • Jun Yong Park
    Affiliations
    Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea

    Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea

    Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea
    Search for articles by this author
  • Do Young Kim
    Affiliations
    Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea

    Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea

    Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea
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  • Sang Hoon Ahn
    Affiliations
    Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea

    Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea

    Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea
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  • Dong Hyun Sinn
    Correspondence
    Corresponding author. Dong Hyun Sinn, MD, PhD, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea. Tel: 82-2-3410-3409; Fax: 82-2-3410-6983
    Affiliations
    Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea
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  • Seung Up Kim
    Correspondence
    Corresponding author. Seung Up Kim, MD, PhD, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun–gu, Seoul, 03722, Republic of Korea, Yonsei-ro 50, Seodaemun-gu, Seoul, Korea. Tel: 82-2-2228-1930; Fax: 82-2-393-6884
    Affiliations
    Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea

    Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea

    Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea
    Search for articles by this author
  • Author Footnotes
    1 Ji Hyun Lee and Beom Kyung Kim equally contributed to this work
Published:March 30, 2021DOI:https://doi.org/10.1016/j.ejim.2021.02.019

      Abstract

      Background/aims

      Whether entecavir (ETV) or tenofovir disoproxil fumarate (TDF) affords the better prognosis after curative treatment of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) remains unclear. We compared recurrence and death rates between patients taking ETV and those taking TDF.

      Methods

      Between 2013 and 2017, patients with HBV-related HCC who had undergone hepatic resection (n=421) or radiofrequency ablation (n=305) as first-line anti-HCC treatment in three institutes were consecutively enrolled. All patients received ETV or TDF as a first-line antiviral. The cumulative probabilities of recurrence and death were assessed. We adjusted for viral factors, including the HBV-DNA load, and tumor and demographic factors.

      Results

      During the study period (median 46.6 [interquartile range 25.3–58.9] months), 227 patients experienced recurrence and 53 died. In the ETV (n=405) and TDF (n=321) groups, the annual incidences of recurrence (10.61 and 11.21 per 100 person-years, respectively; P=727) and death (2.28 and 1.79 per 100 person-years, respectively; P=277) were similar, with adjusted hazard ratios (aHRs) of 0.932 (P=0.622) and 0.667 (P=0.193), respectively. When stratified by treatment modality and the timing of antiviral therapy commencement, the values were similar (all P>0.05). Inverse probability of treatment weighting (IPTW) analyses yielded results that were similar in the two groups in terms of recurrence (aHR=1.038, P=0.963) and death (aHR=0.799, P=0.431). Furthermore, the early (<2 years) and late (≥2 years) recurrence risks were not statistically different in the two groups (both P=0.400), as confirmed by IPTW analysis (P=0.502 and P=0.377, respectively).

      Conclusions

      The prognoses in terms of recurrence and death after curative treatment of HBV-related HCC were not statistically different between the ETV and TDF groups. Further validation studies are needed.

      Keywords

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