Effects of lamivudine on outcome after liver resection for hepatocellular carcinoma in patients with active replication of hepatitis B virus |
| |
Authors: | Shoji Kubo Hiromu Tanaka Shigekazu Takemura Satoshi Yamamoto Seikan Hai Tsuyoshi Ichikawa Shintaro Kodai Hiroji Shinkawa Hiroki Sakaguchi Akihiro Tamori Daiki Habu Shuhei Nishiguchi |
| |
Institution: | Departments of Hepato-Biliary-Pancreatic Surgery and;Hepatology, Osaka City University Graduate School of Medicine, Osaka and;Division of Hepatobiliary and Pancreatic Diseases, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan |
| |
Abstract: | Aim: Patients with high serum hepatitis B virus (HBV) DNA concentrations are at high risk of tumor recurrence after liver resection for HBV-related hepatocellular carcinoma (HCC). Methods: Among 24 patients with high serum HBV DNA concentrations who underwent liver resection for HBV-related HCC, postoperative lamivudine therapy was chosen by 14 (lamivudine group). The other 10 patients were controls. Results: Clinicopathologic findings did not differ between the groups. Tumor-free survival rate after surgery was significantly higher in the lamivudine than the control group ( P = 0.0086). By univariate analysis, multiple tumors were also a risk factor for a short tumor-free survival. By multivariate analysis, lack of lamivudine therapy and multiple tumors were independent risk factors for a short tumor-free survival. In four patients YMDD mutant viruses were detected after beginning lamivudine administration; in two of them, adefovir dipivoxil was administered because of sustained serum alanine aminotransferase elevations. Conclusion: Lamivudine therapy improved tumor-free survival rate after curative resection of HBV-related HCC in patients with high serum concentrations of HBV DNA, although careful follow up proved necessary for the detection of YMDD mutant viruses. |
| |
Keywords: | adefovir dipivoxil hepatitis B virus hepatocellular carcinoma lamivudine liver resection YMDD mutant virus |
|
|