Effect of oral antiviral treatment on long-term outcomes of radiofrequency ablation therapy for hepatitis B virus-related hepatocellular carcinoma

// Won Sohn 1, 2, * , Tae Wook Kang 3, * , Sun-Kyu Choi 4 , Sin-Ho Jung 4 , Min Woo Lee 3 , Hyo Keun Lim 3, 5 , Ju-Yeon Cho 1, 6 , Sang Goon Shim 7 , Dong Hyun Sinn 1 , Geum-Youn Gwak 1 , Moon Seok Choi 1 , Joon Hyeok Lee 1 , Kwang Cheol Koh 1 , Seung Woon Paik 1 , Hyunchul Rhim 3, # , Yong-Han Paik 1, 5, # 1 Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea 2 Department of Hepatology, Bundang Jesaeng Hospital, Sungnam, Korea 3 Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea 4 Department of Biostatistics and Clinical Epidemiology, Samsung Medical Center, Seoul, Korea 5 Department of Health Science and Technology, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Korea 6 Department of Medicine, Chosun University Hospital, Gwang-Ju, Korea 7 Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea * These authors have contributed equally to this work # These authors share senior authorship Correspondence to: Yong-Han Paik, email: yh.paik@skku.edu Keywords: hepatocellular carcinoma, radiofrequency ablation, chronic hepatitis B, antiviral treatment Received: January 08, 2016 Accepted: May 28, 2016 Published: June 14, 2016 ABSTRACT Objectives: This study aimed to investigate the effect of oral antiviral treatment on the prognosis of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after radiofrequency (RF) ablation. Methods: Between January 2003 and December 2010, 228 patients without a history of antiviral treatment were treated with RF ablation for a single HBV-related HCC. We divided the patients into two groups, patients who received (n=125) or did not receive antiviral treatment (n=103), based on whether oral antiviral treatment was administered after RF ablation. The median duration of antiviral treatment was 60.1 months. HCC recurrence and overall survival were compared in the two groups in the full cohort and the propensity score-matched cohort. Results: In the matched cohort, the probability of HCC recurrence at 5 years was 43.8% for the non-antiviral treatment group and 14.7% for the antiviral treatment group ( p <0.001). The probability of overall survival at 5 years was 77.2% for the non-antiviral treatment group and 93.5% for the antiviral treatment group ( p =0.002). Multivariable analysis showed that risk factors for HCC recurrence included large tumor size (hazard ratio (HR)=1.30, p =0.022), HBV DNA serum level (HR=1.11, p =0.005), and serum AFP level ≥20 ng/mL (HR=1.66, p =0.005). Overall survival was associated with larger tumor size (HR=1.86, p =0.001) and Child-Pugh Class B (HR=2.13, p =0.019). Oral antiviral treatment after RF ablation was significantly associated with a lower risk of tumor recurrence and death (HR=0.33, p <0.001, and HR=0.44, p =0.004). Conclusion : Use of oral antiviral treatment after curative RF ablation was associated with favorable outcomes in terms of tumor recurrence and overall survival in patients with HBV-related HCC.