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Nucleos(t)ide analogues reduce risk for recurrence in HBV-related HCC

Nucleos(t)ide analogues for hepatitis B virus infection decreased a patient’s risk for infection-related hepatocellular carcinoma after curative therapy with radiofrequency ablation, according to published findings.

“To the best of our knowledge, this is the first study to report on the positive effect of [nucleos(t)ide analogues] therapy on the prevention of HCC recurrence after [radiofrequency ablation] treatment. … Further prospective studies are mandatory for confirmation of our findings,” Chun-Ying Wu, MD, PhD, MPH, of the division of gastroenterology and hepatology, Taichung Veterans General Hospital, Taiwan, and colleagues wrote.

The researchers used data from the Taiwan National Health Insurance Research database and screened 48,807 patients with newly diagnosed HBV-related HCC between July 2004 and December 2012. Of these, 850 patients received radiofrequency ablation as a potentially curative treatment for HCC. Researchers randomly matched patients treated with nucleos(t)ide analogues with patients in the untreated cohort by age, sex, cirrhosis and the time between radiofrequency ablation and initiation of nucleos(t)ide analogues treatment.

A total of 133 patients from the nucleos(t)die analogues-treated group and 266 in the untreated group were included in the final analysis. Of these, 188 patients developed recurrent HCC in 2 years; 39.1% in the treated group (n = 52) vs. 51.1% in the untreated group (n = 136; P < .05).

After adjusting for competing mortality, the 2-year HCC recurrence rate in the nucleos(t)ide analogues-treated group was lower (41.8%; 95% CI, 32.9-50.6) compared with the untreated group (54.3%; 95% CI, 48-60.6).

The cumulative 3-year HCC recurrence rate remained lower in the nucleos(t)ide analogues-treated group compared with the untreated group (52.7% vs. 57.6%), but did not reach significance (P = .07).

Cox's regression analysis showed nucleos(t)ide analogues treatment was independently associated with a decreased risk for HCC recurrence (HR = 0.69; 95% CI, 0.5-0.95). In addition, multivariate stratified analyses verified the same association in nearly all patient subgroups (HR = 1).

“These observations further confirmed the association between [nucleos(t)ide analogues] therapy and decreased risk of HCC recurrence in HCC patients after curative radiofrequency ablation,” the researchers wrote, noting that statistical significance was reached in multiple subgroups, including men (HR = 0.62; 95% CI, 0.43-0.88) and those without diabetes mellitus (HR = 0.65; 95% CI, 0.45-0.97).

Disclosure: The researchers report no relevant financial disclosures.