Prior surveillance and antiviral treatment improve the prognosis of HCC developed in HBV patients in the West - 16/01/21
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| Iconographies | 1 |
| Vidéos | 0 |
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Highlights |
• | In a French expert center, 14% of hepatocellular carcinoma complicating Hepatitis B infection are diagnosed in a non-cirrhotic liver. |
• | Antiviral treatment is associated with less aggressive tumor and better survival. |
• | Surveillance was associated with lower tumor burden and patients were more amenable to curative treatment with better outcome. |
Summary |
Background |
In Western countries, hepatocellular carcinoma (HCC) in hepatitis B (HBV) patients without cirrhosis was poorly studied. The aim was to describe the characteristics and outcome of HBV-related HCC according to fibrosis stage.
Method |
All patients with chronic HBV infection and HCC discussed in a multidisciplinary tumor board between 2007 and 2017 were retrospectively included.
Results |
A total of 152 out of 2,038 HCC patients had underlying HBV infection. HBV viral load>2000IU/ml, positive HBeAg and Hepatitis D coinfection were observed in 41%, 13% and 13% of cases, respectively. HCC was uninodular in 53%, associated with portal thrombosis in 16% and/or metastasis in 9% of cases. 130 patients (86%) had cirrhosis. No difference regarding HCC risk factors and viral characteristics was observed according to fibrosis stage. 5-year survival was 48%(47% on cirrhosis versus 57% without cirrhosis, P=0.26). At HCC diagnosis, 47% and 32% of cirrhotic and non-cirrhotic patients received an antiviral treatment (AVT), which was associated with less aggressive tumor and better survival (P=0.005). In cirrhosis, screening was associated with a lower tumor burden and patients were more amenable to curative treatment with better outcome (P<0.001).
Conclusion |
HBV represents 8% of HCC etiologies without differences of viral characteristics according to fibrosis stage. AVT and surveillance were associated with less aggressive tumors, better access to curative treatment and outcome.
Le texte complet de cet article est disponible en PDF.Keywords : Hepatocellular carcinoma, Hepatitis B infection, Overall survival, Prognostic factors
Abreviations : 95% CI, AVT, BCLC, HBV, HCC, HCV, HDV, HIV, HR, IQR, OS, MDT, RFA, SD
Plan
Vol 45 - N° 1
Article 101436- janvier 2021 Retour au numéro
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