Anti-viral therapy is associated with improved survival but is underutilised in patients with hepatitis B virus-related hepatocellular carcinoma: real-world east and west experienceopen access
- Authors
- Chen, Vincent Lingzhi; Yeh, Ming Lun; Le, An Kim; Jun, Myung Joon; Saeed, Waqar Khalid; Yang, Ju Dong; Huang, Chung Feng; Lee, HY; Tsai, Pei Chien; Lee, Mei Hsuan; Giama, N.; Kim, N. G.; Nguyen, P. P.; Dang, H.; Ali, H. A.; Zhang, N.; Huang, J. -F.; Dai, C. -Y.; Chuang, W. -L.; Roberts, L. R.; Jun, Dae Won; Lim, Y. -S.; Yu, M. -L.; Nguyen, M. H.
- Issue Date
- Jul-2018
- Publisher
- WILEY
- Citation
- ALIMENTARY PHARMACOLOGY & THERAPEUTICS, v.48, no.1, pp.44 - 54
- Indexed
- SCIE
SCOPUS
- Journal Title
- ALIMENTARY PHARMACOLOGY & THERAPEUTICS
- Volume
- 48
- Number
- 1
- Start Page
- 44
- End Page
- 54
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/16835
- DOI
- 10.1111/apt.14801
- ISSN
- 0269-2813
- Abstract
- Background: Hepatitis B virus (HBV) is the leading cause of hepatocellular carcinoma (HCC) worldwide. It remains incompletely understood in the real world how anti-viral therapy affects survival after HCC diagnosis. Methods: This was an international multicentre cohort study of 2518 HBV-related HCC cases diagnosed between 2000 and 2015. Cox proportional hazards models were utilised to estimate hazard ratios (HR) with 95% (CI) for anti-viral therapy and cirrhosis on patients' risk of death. Results: Approximately, 48% of patients received anti-viral therapy at any time, but only 17% were on therapy at HCC diagnosis (38% at US centres, 11% at Asian centres). Anti-viral therapy would have been indicated for >60% of the patients not on anti-viral therapy based on American criteria. Patients with cirrhosis had lower 5-year survival (34% vs 46%; P<0.001) while patients receiving anti-viral therapy had increased 5-year survival compared to untreated patients (42% vs 25% with cirrhosis and 58% vs 36% without cirrhosis; P<0.001 for both). Similar findings were seen for other patient subgroups by cancer stages and cancer treatment types. Anti-viral therapy was associated with a decrease in risk of death, whether started before or after HCC diagnosis (adjusted HR 0.62 and 0.79, respectively; P<0.001). Conclusions: Anti-viral therapy improved overall survival in patients with HBV-related HCC across cancer stages and treatment types but was underutilised at both US and Asia centres. Expanded use of anti-viral therapy in HBV-related HCC and better linkage-to-care for HBV patients are needed.
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