BMC cancer · 2025
Preoperative HBsAg seroclearance affects long-term outcomes for hepatitis B virus-related hepatocellular carcinoma after liver resection: a multicenter analysis.
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Liu Si-Yu, Zhu Lin, Lu Wen-Feng, Xie Gui-Lin, Liang Lei, Liu Jun-Wei, Ye Bin, Dai Mu-Gen
Аннотация
BACKGROUND & AIMS: We aimed to investigate the impact of HBsAg seroclearance on the long-term prognosis of HBV-related HCC following curative liver resection.
METHODS: Patients treated with curative-intent hepatectomy for HBV-related HCC in 4 Chinese hospitals were enrolled. Patients were stratified into HBsAg-positive and HBsAg-seroclearance groups. Overall survival (OS) and time-to-recurrence (TTR) were compared between HBsAg-positive and HBsAg-seroclearance patients using propensity score matching (PSM). Independent risk factors of OS, cancer-specific survival (CCS) and TTR were identified by univariable and multivariable Cox regression and competing risk regression analyses.
RESULTS: Among 1008 HBV-related HCC patients, 81 (8.0%) patients achieved HBsAg seroclearance before surgery. Patients in HBsAg-seroclearance groups had better liver function reserve. Postoperative morbidity was comparable between the two groups before and after PSM. In the entire cohort, the Kaplan-Meier curves showed that HBsAg-seroclearance patients had better OS (p = 0.022) and TTR (p < 0.001). However, there was no significant difference between the two groups of patients regarding OS (p = 0.134) in the PSM cohort. Multivariable Cox regression and competing risk regression analyses demonstrated that HBsAg seroclearance was independently associated with lower TTR (p < 0.05), but not with better OS and CSS (p > 0.05).
CONCLUSIONS: Preoperative HBsAg seroclearance is associated with a lower risk of TTR for HBV-related HCC among patients undergoing curative hepatectomy.
METHODS: Patients treated with curative-intent hepatectomy for HBV-related HCC in 4 Chinese hospitals were enrolled. Patients were stratified into HBsAg-positive and HBsAg-seroclearance groups. Overall survival (OS) and time-to-recurrence (TTR) were compared between HBsAg-positive and HBsAg-seroclearance patients using propensity score matching (PSM). Independent risk factors of OS, cancer-specific survival (CCS) and TTR were identified by univariable and multivariable Cox regression and competing risk regression analyses.
RESULTS: Among 1008 HBV-related HCC patients, 81 (8.0%) patients achieved HBsAg seroclearance before surgery. Patients in HBsAg-seroclearance groups had better liver function reserve. Postoperative morbidity was comparable between the two groups before and after PSM. In the entire cohort, the Kaplan-Meier curves showed that HBsAg-seroclearance patients had better OS (p = 0.022) and TTR (p < 0.001). However, there was no significant difference between the two groups of patients regarding OS (p = 0.134) in the PSM cohort. Multivariable Cox regression and competing risk regression analyses demonstrated that HBsAg seroclearance was independently associated with lower TTR (p < 0.05), but not with better OS and CSS (p > 0.05).
CONCLUSIONS: Preoperative HBsAg seroclearance is associated with a lower risk of TTR for HBV-related HCC among patients undergoing curative hepatectomy.