Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Jun 21, 2010; 16(23): 2931-2942
Published online Jun 21, 2010. doi: 10.3748/wjg.v16.i23.2931
Postoperative adjuvant antiviral therapy for hepatitis B/C virus-related hepatocellular carcinoma: A meta-analysis
Ruo-Yu Miao, Hai-Tao Zhao, Hua-Yu Yang, Yi-Lei Mao, Xin Lu, Yi Zhao, Chang-Ning Liu, Shou-Xian Zhong, Xin-Ting Sang, Jie-Fu Huang
Ruo-Yu Miao, Hai-Tao Zhao, Hua-Yu Yang, Yi-Lei Mao, Xin Lu, Shou-Xian Zhong, Xin-Ting Sang, Jie-Fu Huang, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Yi Zhao, Chang-Ning Liu, Bioinformatics Research Group, Institute of Computing Technology, Chinese Academy of Sciences, Beijing 100190, China
Author contributions: Miao RY and Zhao HT contributed equally to this article; Miao RY, Yang HY and Mao YL performed the majority of analyses; Zhao HT, Lu X, Zhao Y and Liu CN provided analytical tools and were involved in editing the manuscript; Zhao HT, Zhong SX, Sang XT and Huang JF provided financial support for this work; Miao RY and Zhao HT designed the study and wrote the manuscript.
Supported by National Natural Science Foundation of China, No. 30970623 and No. 30600729, International Science and Technology Cooperation Projects, 2010DFA31840
Correspondence to: Hai-Tao Zhao, Associate Professor, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan 1, Wangfujing, Beijing 100730, China. zht@ebiomed.org
Telephone: +86-10-65296042 Fax: +86-10-65296043
Received: March 3, 2010
Revised: April 18, 2010
Accepted: April 25, 2010
Published online: June 21, 2010
Abstract

AIM: To investigate the impact of postoperative antiviral treatment on tumor recurrence and survival of patients with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection-related primary hepatocellular carcinoma (HCC) after curative therapy.

METHODS: We performed a meta-analysis of randomized and non-randomized control trials from electronic search and manual search. The fixed effect model of Mantel-Haenszel method and the random effect model of Der Simonian and Laird method were used for homogeneous and heterogeneous studies, respectively. Seven HCV-related studies, three HBV-related studies and three studies on HBV or HCV-related HCC were identified.

RESULTS: A total of 1224 patients were included in this analysis. The estimated odds ratios (OR) for the 1-, 2-, 3- and 5-year recurrence were 0.54 [15.4% vs 24.1%, 95% confidence interval (CI): 0.32-0.89, P = 0.02], 0.42 (36.9% vs 58.0%, 95% CI: 0.19-0.90, P = 0.03), 0.37 (47.9% vs 63.8%, 95% CI: 0.19-0.71, P = 0.003), and 0.32 (66.7% vs 74.3%, 95% CI: 0.15-0.66, P = 0.002), respectively; and the OR for the 1-, 2-, 3-, 5- and 7-year mortality were 0.23 (1.2% vs 9.1%, 95% CI: 0.07-0.71, P = 0.01), 0.31 (6.4% vs 22.1%, 95% CI: 0.12-0.79, P = 0.01), 0.43 (12.7% vs 20.8%, 95% CI: 0.21-0.89, P = 0.02), 0.42 (25.1% vs 42.0%, 95% CI: 0.27-0.66, P = 0.0002) and 0.28 (31.9% vs 52.2%, 95% CI: 0.13-0.59, P = 0.0008).

CONCLUSION: This meta-analysis indicates the postoperative antiviral therapy, interferon in particular, may serve as a favorable alternative to reduce recurrence and mortality in patients with HBV/HCV related HCCs.

Keywords: Antiviral therapy; Hepatitis B virus; Hepatitis C virus; Hepatocellular carcinoma; Recurrence; Survival