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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Article info
Publication history
Published online: March 30, 2021
Accepted:
February 28,
2021
Received in revised form:
February 10,
2021
Received:
November 17,
2020
Identification
Copyright
© 2021 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
