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Hepatocellular Carcinoma: High Hepatitis B Viral Load and Mortality in Patients Treated with Transarterial Chemoembolization

医学 肝细胞癌 内科学 危险系数 胃肠病学 肝癌 置信区间 恶化 乙型肝炎 癌症 乙型肝炎病毒 肿瘤科 免疫学 病毒
作者
Su Jong Yu,Jeong‐Hoon Lee,Eun Sun Jang,Eun Ju Cho,Min‐Sun Kwak,Jung‐Hwan Yoon,Hyo-Suk Lee,Chung Yong Kim,Yoon Jun Kim
出处
期刊:Radiology [Radiological Society of North America]
卷期号:267 (2): 638-647 被引量:29
标识
DOI:10.1148/radiol.13121498
摘要

To determine the relationship between hepatitis B virus (HBV) DNA level and the survival of patients with hepatocellular carcinoma treated by means of transarterial chemoembolization (TACE).This study was approved by the institutional review board, and the requirement to obtain informed consent was waived. From January 2005 to March 2007, 183 patients with HBV-related hepatocellular carcinoma who underwent TACE but never received antiviral therapy were consecutively enrolled in our cohort. All patients were tested for pre-TACE serum level of HBV DNA, and overall survival was measured from date of enrollment until death from any cause. Radiologic progression was evaluated by using the modified response evaluation criteria in solid tumors by means of independent radiologic assessment.The median overall survival was 19 months (95% confidence interval: 13.7, 24.3) and median time to progression was 4 months (95% confidence interval: 3.03, 4.97). Multivariate analysis revealed that a high pre-TACE serum level of HBV DNA (> 2000 IU/L) was an independent risk factor for reduced overall survival (P = .021; hazard ratio [HR], 1.725), high cancer progression-related mortality (P = .014; HR, 1.936), and hepatic failure-related mortality associated with cancer progression (P = .005, HR, 3.908). Pre-TACE level of HBV DNA did not significantly affect hepatic failure-related mortality that was not caused by cancer progression.A high pre-TACE serum level of HBV DNA was associated with poor overall survival and rapid progression of hepatocellular carcinoma after TACE, and the cause of mortality was not hepatitis exacerbation but cancer progression.
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