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Ultrasound-guided percutaneous ablation outcomes in patients with HBcAb positivity non-B non-C hepatocellular carcinoma: a multicenter long-term follow-up study

Year: 2025

Type: article

Abstract: BACKGROUND: Hepatitis B core antibody (HBcAb) positivity marks prior and occult hepatitis B virus (HBV) exposure and is common in non-B non-C hepatocellular carcinoma (NBNC-HCC) patients, yet its prognostic role in ablation-treated cohorts remains unclear. We evaluated the impact of HBcAb status on ablation treatment outcomes in NBNC-HCC patients. METHODS: This multicenter retrospective study enrolled 1184 HCC patients at Barcelona Clinic Liver Cancer stage 0-B subjected to ablation from 2009 to 2022. Patients were classified into HBV-HCC ( n = 1037), HBcAb-positive NBNC-HCC ( n = 82), and HBcAb-negative NBNC-HCC ( n = 65) groups. Overlap weighting balanced baseline confounders. Survival outcomes were evaluated, including recurrence-free survival (RFS) and overall survival (OS). RESULTS: After adjustment, HBcAb-positive NBNC-HCC and HBV-HCC groups showed comparable RFS ( P = 0.565) and OS ( P = 0.590). HBcAb-positive NBNC-HCC patients exhibited numerically lower 5-year OS rates than HBcAb-negative counterparts (67.4% vs. 90.6%, P = 0.302). Prothrombin time independently predicted RFS in HBcAb-positive patients ( P < 0.001). Subgroup analysis demonstrated significantly worse RFS in HBcAb-positive NBNC-HCC patients with cirrhosis [hazard ratio (HR) = 2.09, 95% confidence interval (CI): 1.11-3.93], PT > 14 s (HR = 4.37, 95% CI: 2.74-6.69), or total bilirubin > 34.2 μmol/L (HR = 3.35, 95% CI: 1.65-6.97) compared to HBV-HCC (all P for interaction <0.05). CONCLUSION: The ablation outcomes in HBcAb-positive NBNC-HCC patients were comparable to those in HBV-HCC. Moreover, the observed poorer RFS in HBcAb-positive NBNC-HCC patients with worse liver function highlights the need for targeted surveillance and individualized management in this population.

Source: International Journal of Surgery

DOI: 10.1097/js9.0000000000003875