Thursday, May 8, 2014

High Preoperative Hepatitis B Surface Antigen Level Predicts Hepatocellular Carcinoma Recurrence in Patients With Low HBV DNA

In a Chinese study reported in JAMA Surgery, Huang et al found that preoperative elevated hepatitis B virus (HBV) surface antigen (HBsAg) level is an independent risk factor for hepatocellular carcinoma recurrence and mortality in patients with low HBV DNA levels undergoing hepatic resection.

Key Points:
  • High preoperative HBsAg level was associated with significantly poorer 5-year disease-free survival and overall survival in patients with low baseline HBV DNA.
  • High HBsAg level was an independent predictor of hepatocellular carcinoma recurrence and mortality.
 
Disease-Free Survival and Overall Survival
The study was a retrospective analysis of 1,062 HBsAg-seropositive patients with low HBV DNA levels (< 200 IU/mL) who underwent partial hepatectomy for hepatocellular carcinoma. Median follow-up was 60 months. Risk of tumor recurrence increased with HBsAg levels ≥ 1,000 IU/mL. For patients with low (< 1000 IU/mL; n = 622) vs high (≥ 1,000 IU/mL, n = 440) HBsAg level, 5-year disease-free survival was 46.1% vs 34.1% (P = .002) and overall survival was 57.5% vs 48.8% (P = .004). 

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