Effect of antiviral therapy on 3-year recurrence and prognosis of hepatocellular carcinoma after curative radiofrequency ablation
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND The impact of entecavir (ETV), tenofovir disoproxil fumarate (TDF), and tenofovir alafenamide fumarate (TAF) on long-term recurrence and overall survival in patients with hepatitis B cirrhosis-related hepatocellular carcinoma (HCC) who undergo curative radiofrequency ablation (RFA) remains unclear. AIM To compare the 3-year recurrence and survival rates among HCC patients receiving these three first-line oral anti-hepatitis B virus (anti-HBV) agents after RFA. METHODS This retrospective cohort study included patients with hepatitis B cirrhosis who were initially diagnosed with HCC at Tianjin Third Central Hospital, China, from August 2018 to December 2020, and had complete clinical data. All patients were followed up for at least 144 weeks. Cox regression analysis was performed to identify independent risk factors for HCC recurrence. Recurrence-free survival was analyzed using Kaplan-Meier curves, and Cox regression models were constructed after adjusting for gamma-glutamyl transferase, alpha-fetoprotein, and Barcelona Clinic Liver Cancer staging. RESULTS A total of 319 patients receiving oral anti-HBV therapy were divided into three groups: ETV group (n = 191), TDF group (n = 76), and TAF group (n = 52). At 6 and 12 months, there were no significant differences in recurrence rates between the groups. However, at 24 and 36 months, the TDF and TAF groups exhibited significantly lower recurrence rates compared with the ETV group [24 months: TDF, hazard ratio (HR) = 0.51, 95% confidence interval (CI): 0.29-0.91, P = 0.022; TAF, HR = 0.54, 95%CI: 0.28-1.03, P = 0.046; 36 months: TDF, HR = 0.57, 95%CI: 0.35-0.93, P = 0.025; TAF, HR = 0.54, 95%CI: 0.31-0.96, P = 0.037]. The 3-year mortality rates were similar across the three groups (ETV: 21.47%, TDF: 18.42%, TAF: 23.08%; P = 0.790). CONCLUSION Among patients with hepatitis B cirrhosis-related HCC, TDF and TAF are associated with lower 2-year and 3-year HCC recurrence rates after curative RFA treatment compared with ETV. However, there were no significant differences in 3-year mortality rates between the ETV, TDF, and TAF groups.
Authors: Bai-Guo Xu, Xue Zhang, Fang Liu, Feng-Hui Li, Xu Zhang, Hui-Ling Xiang, Jing Liang
Language: English
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4416126453