Lamivudine antiviral treatment after radical surgery prolongs disease-free survival of patients with hepatitis B virus-related liver cancer / 临床肝胆病杂志

ABSTRACT

Objective To investigate whether lamivudine antiviral treatment after radical surgery can prolong disease-free survival of patients with hepatitis B virus-related liver cancer.Methods A total of 120 patients with hepatitis B virus-related liver cancer who underwent conventional radical surgery in Dongfeng Hospital Affiliated to Hubei Medical College from March 2014 to March 2016 were enrolled,and among these patients,60 were given conventional treatment (group A) and 60 were given lamivudine antiviral treatment (group B).ELISA was used to measure serum HBV DNA level.The t-test was used for comparison of continuous data between groups,the chi-square test was used for comparison of categorical data between groups,the Kaplan-Meier method was used to compare disease-free survival rate and recurrence rate between groups,and the Spearman method was used to investigate the correlation between serum HBV DNA level and survival time.Results According to the results of the 3-year follow-up,71 patients (59.17％) died (group A46 patients died of tumor and 4 died of hepatic encephalopathy;group B20 died of tumor and 1 died of hepatic encephalopathy).Compared with group A,group B had significantly lower recurrence rate (48.33％ vs 90.00％,x2 =16.98,P ＜0.001) and mortality rate within 3 years (35.00％ vs 83.33％,x2 =10.34,P ＜ 0.001).Group B had significantly higher mean disease-free survival time and 1-,2-,and 3-year dis-ease-free survival rates than group A(t =9.82,x2 =7.87,11.43,and 7.98,all P ＜ 0.001).After surgery,group B had a significantly lower serum HBV DNA load than group A [(0.008 1 ±0.003 2) × 105 copies/ml vs (0.014 3 ±0.008 9) × 105 copies/ml,t =18.54,P ＜ 0.001].In group A,there were significant differences in 1-,2-,and 3-year disease-free survival rates between patients with serum HBV DNA load ≥ 1.0 × 105 copies/ml and those with serum HBV DNA load ＜ 1.0 × 105 copies/ml (x2 =8.57,P ＜ 0.05),and further analysis showed that there were significant differences in 1-,2-,and 3-year disease-free survival rates (x2 =4.36,5.36,and 9.53,P ＜ 0.05);in group B,there were no significant differences in 1-,2-,and 3-year disease-free survival rates between these two groups of patients (P ＞ 0.05).Serum HBV DNA expression was positively correlated with patients' survival time (r =0.67,P ＜ 0.001).Conclusion Lamivudine antiviral therapy after radical surgery can effectively reduce serum HBV DNA level,and helps to prolong the disease-free survival time of patients with hepatitis B virus-related liver cancer.