1. Tenofovir versus entecavir on recurrence and mortality of hepatitis B virus-related hepatocellular carcinoma after curative therapy.
- Author
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Chang KC, Su TH, Liao SH, Tseng TC, Huang SC, Hsu SJ, Hong CM, Liu CH, Yang HC, Liu CJ, and Kao JH
- Subjects
- Humans, Male, Female, Middle Aged, Retrospective Studies, Aged, Hepatitis B, Chronic complications, Hepatitis B, Chronic drug therapy, Hepatitis B, Chronic mortality, Taiwan epidemiology, Hepatitis B virus, Adult, Carcinoma, Hepatocellular mortality, Carcinoma, Hepatocellular virology, Liver Neoplasms mortality, Liver Neoplasms virology, Tenofovir therapeutic use, Neoplasm Recurrence, Local, Guanine analogs & derivatives, Guanine therapeutic use, Antiviral Agents therapeutic use
- Abstract
Background: Tenofovir disoproxil fumarate (TDF) and entecavir (ETV) reduce the risk of hepatocellular carcinoma (HCC) in patients of hepatitis B. This study compared the difference between ETV and TDF on risk of HCC recurrence and mortality in patients with HBV-related HCC after curative intent treatment., Methods: Patients with HBV-related HCC who received HCC treatment (surgery or radiofrequency ablation [RFA]) and underwent long-term ETV or TDF therapy were retrospectively included. Baseline characteristics including age, sex, antiviral therapy, liver reserve, HCC stages, pathology reports and treatment modality were obtained. The risk of tumor recurrence, all-cause mortality, HCC-related mortality, and liver function were compared., Results: We identified 390 HBV-related HCC patients with curative intent treatment for HCC and treated with ETV (n = 328) or TDF (n = 62) between January 2011 and December 2020. The median age was 60 years, and 90.7% patients were males. After a median follow-up of 29 months, 186 patients developed recurrent HCC and 111 died. The baseline characteristics were comparable except more ALBI grade 3 patients in TDF group (76% vs. 48%, P < 0.001). Compared to ETV group, TDF users had lower all-cause mortality (adjusted hazard ratio [aHR]: 0.38, P = 0.003), and HCC-related mortality (aHR: 0.23, P = 0.005). Lower recurrence rate was noticed in TDF users after inverse probability of treatment weighting (IPTW). TDF users had improved ALBI grade and FIB-4 index compared with ETV groups., Conclusion: TDF therapy is associated with a reduced risk of HCC-related outcomes among patients with HBV-related HCC after curative intent treatment compared with ETV usage., (Copyright © 2024 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.)
- Published
- 2024
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