Prognosis of HBV-related Hepatocellular Carcinoma Patients Treated with Nucleos(t)ide Analogue Therapy Combined with Transarterial Chemoembolization

Objective  To investigate the efficacy of nucleos(t)ide analogue (NAs) plus transarterial chemoembolization (TACE) on the overall survival of the patients with postoperative hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).

Methods We retrospectively analyzed a total of 345 patients with HBV-related HCC and the risk factors of recurrence. Among them, 89 patients received NAs plus TACE therapy, while other 256 patients received adjuvant TACE therapy alone. Propensity-score matching analysis was used to balance the bias between groups.

Results The 90-day mortality of the combination therapy group was slightly lower than that of the adjuvant TACE group (2.2% vs. 3.1%, P=0.672). The 1-, 3-, and 5-year overall survival were significantly higher in the combination therapy group than those in the adjuvant TACE group (93%, 66%, 45% vs. 90%, 54%, 36%, P=0.014). Moreover, the combination therapy group also had significantly higher overall survival than the adjuvant TACE group after propensity-score analysis (93%, 67%, 45% vs. 87%, 46%, 24%, P＜0.001). However, the subgroup analysis based on tumor stage revealed that the combination therapy group had significantly higher overall survival than the adjuvant TACE group of those with BCLC-A/B HCC.

Conclusion  Postoperative NAs plus TACE treatment modality is effective in reducing the perioperative mortality and improving the overall survival of HBV-related HCC patients with preoperative HBV DNA≥103 IU/ml and the risk factors of recurrence.