Hepatitis B viral load predicts survival in hepatocellular carcinoma patients treated with sorafenib
Seungtaek Lim
Department of Internal Medicine, Konyang University Hospital, Daejon, Korea
Search for more papers by this authorJungwoo Han
Department of Pediatric Hemato-Oncology, Yonsei Cancer Center, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorGun Min Kim
Division of Medical Oncology, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorKwang-Hyub Han
Division of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
Department of Internal Medicine, Severance Hospital Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorCorresponding Author
Hye Jin Choi
Division of Medical Oncology, Yonsei University College of Medicine, Seoul, Korea
Department of Internal Medicine, Severance Hospital Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
Correspondence
Professor Hyejin Choi, Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. Email: [email protected]
Search for more papers by this authorSeungtaek Lim
Department of Internal Medicine, Konyang University Hospital, Daejon, Korea
Search for more papers by this authorJungwoo Han
Department of Pediatric Hemato-Oncology, Yonsei Cancer Center, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorGun Min Kim
Division of Medical Oncology, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorKwang-Hyub Han
Division of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
Department of Internal Medicine, Severance Hospital Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorCorresponding Author
Hye Jin Choi
Division of Medical Oncology, Yonsei University College of Medicine, Seoul, Korea
Department of Internal Medicine, Severance Hospital Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
Correspondence
Professor Hyejin Choi, Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. Email: [email protected]
Search for more papers by this authorAbstract
Background and Aim
Sorafenib is now considered as a standard treatment for advanced hepatocellular carcinoma (HCC). We evaluated the effect of hepatitis B virus (HBV) DNA titers on prognosis in HCC patients treated with sorafenib.
Methods
From 2008 to 2012, 78 HBV-related HCC patients who received sorafenib treatment at Severance Hospital were included in our analysis. The effect of pretreatment HBV-DNA levels on clinical outcomes for use in predicting prognosis after treatment with sorafenib was examined by univariate and multivariate analysis.
Results
Median overall survival and median progression-free survival were 5.2 months (95% confidence interval: 4.0–6.4) and 3.5 months (95% confidence interval: 2.3–4.7), respectively. Multivariate analysis revealed high levels of HBV-DNA (> 2000 IU/mL) to be an independent risk factor for worse overall survival (P = 0.005; hazard ratio, 2.85) and disease progression among patients who did not receive concomitant prophylactic antiviral therapy during sorafenib treatment (P = 0.008; hazard ratio, 87.4). Moreover, viral reactivation occurred more frequently in patients who did not receive concomitant prophylactic antiviral therapy than in those who did (4/38 vs 0/40; P = 0.025).
Conclusion
Higher HBV-DNA levels prior to sorafenib treatment were associated with poorer prognosis and increased viral reactivation thereafter. These results suggest the potential usefulness of prophylactic antiviral therapy when treating HBV-related HCC patients with sorafenib.
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