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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