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Efficacy of Nucleoside Analogs for Chronic Hepatitis B Virus-Related Hepatocellular Carcinoma After Curative Treatment: A Meta-Analysis

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Abstract

Background and Aim

The efficacy of nucleoside analogs (NAs) for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after curative treatment remains unclear. The present study aimed to evaluate the efficacy of these agents by conducting a comprehensive meta-analysis of available studies.

Methods

We searched several databases including Pubmed, Embase, Cochrane Library, Clinical Trials, and Web of Science, according to PRISMA guidelines. We considered all randomized controlled trials and cohort studies that met the inclusion criteria. Statistical analyses were conducted using Review Manager 5.3 and Stata 14.0.

Results

Twenty-one studies with 8752 participants were included in the final analysis. The pooled data showed that patients treated with NAs had significantly lower 1- and 3-year HCC recurrence rates (relative risk [RR] 0.76, 95% confidence interval [CI] 0.65–0.90; P = 0.001 and RR 0.79, 95% CI 0.71–0.88; P < 0.001, respectively), but there was no difference in 5-year recurrence rates (RR 0.87, 95% CI 0.74–1.03; P = 0.10). Regarding overall survival (OS), patients treated with NAs had significantly higher 1-, 3-, and 5-year OS rates (RR 1.05, 95% CI 1.02–1.08; P = 0.003; RR 1.25, 95% CI 1.16–1.34; P < 0.001; and RR 1.28, 95% CI 1.18–1.39; P < 0.001, respectively).

Conclusion

NA therapy has the potential to reduce the risk of early recurrence and improve OS in patients with HBV-related HCC after curative treatment, compared with placebo or no treatment. Further research including more homogeneous studies with large sample sizes is required to improve the reliability of these conclusions.

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Funding

This study was funded by the National Natural Science Foundation of China (No. 81760497).

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Authors and Affiliations

  1. Department of Gastroenterology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, 43 People’s Avenue, Haikou, 570028, China

    Guangcong Zhang, Peng Liu, Xiaoxi Huang & Xuemei Jiang

  2. Department of Gastroenterology, Zhongshan Hospital of Fudan University, 180 Fenglin Rd., Shanghai, 200032, China

    Xiangnan Yu

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  1. Guangcong Zhang
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Zhang, G., Yu, X., Liu, P. et al. Efficacy of Nucleoside Analogs for Chronic Hepatitis B Virus-Related Hepatocellular Carcinoma After Curative Treatment: A Meta-Analysis. Dig Dis Sci 63, 3207–3219 (2018). https://doi.org/10.1007/s10620-018-5252-8

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