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Prior surveillance and antiviral treatment improve the prognosis of HCC developed in HBV patients in the West.
Clinics and Research in Hepatology and Gastroenterology ( IF 2.7 ) Pub Date : 2020-05-14 , DOI: 10.1016/j.clinre.2020.03.030
Manon Allaire 1 , Weam El Hajj 2 , Ségolène Brichler 3 , Kadiatou Diallo 2 , Daniela Fanica 2 , Lorraine Blaise 2 , Gisèle Nkontchou 2 , Véronique Grando 2 , Fatima Arbadi 2 , Pierre Nahon 4 , Marianne Ziol 5 , Jean-Charles Nault 4 , Nathalie Ganne-Carrié 4
Affiliation  

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 > 2000 IU/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.

更新日期:2020-05-14
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