Background: It is unclear whether entecavir (ETV) and tenofovir disoproxil fumarate (TDF) have different effects on hepatocellular carcinoma (HCC) recurrence and death in patients receiving curative hepatectomy for hepatitis B virus (HBV)-related HCC. Aims: The aim of this study was to compare the long-term efficacy of ETV and TDF in HCC recurrence and overall survival (OS) of patients after curative hepatectomy. Methods: From January 2010 to December 2019, 20,572 patients with HCC who received hepatectomy were screened for study eligibility. Finally, a total of 219 consecutive patients treated with ETV (n = 146) or TDF (n = 73) after curative hepatectomy for HBV-related HCC of Barcelona Clinic Liver Cancer stage 0 or A were analyzed by propensity score matching (PSM) (2:1) analysis and competing risk analysis. HCC recurrence and OS of patients were compared between ETV and TDF groups. Result: After a median follow-up of 52.2 months, 81 patients (37.0%) had HCC recurrence, 33 (15.1%) died, and 5 (2.3%) received liver transplantation. TDF therapy was an independent protective factor for HCC recurrence compared with ETV therapy (HR, 1.687; 95% CI, 1.027–2.770, p = 0.039); however, no difference in the risk of death or liver transplantation. Results were similar in competing risk analysis. We further found that TDF therapy was significantly associated with a lower risk of late recurrence (HR, 4.705; 95% CI, 1.763–12.558, p = 0.002), but not in early recurrence. Conclusions: TDF therapy is associated with a significantly lower risk of HCC recurrence, especially of late recurrence, than ETV therapy among patients who undergo curative hepatectomy for HBV-related early-stage HCC.
Liver Cancer

中文翻译：

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替诺福韦在根治性切除术后 BCLC 0/A 期肝细胞癌的三级预防方面优于恩替卡韦

背景：目前尚不清楚恩替卡韦 (ETV) 和富马酸替诺福韦二吡呋酯 (TDF) 是否对乙型肝炎病毒 (HBV) 相关 HCC 接受根治性肝切除术的患者的肝细胞癌 (HCC) 复发和死亡有不同的影响。目的：本研究的目的是比较 ETV 和 TDF 在治愈性肝切除术后患者 HCC 复发和总生存期 (OS) 中的长期疗效。方法：从 2010 年 1 月至 2019 年 12 月，对 20,572 名接受肝切除术的 HCC 患者进行了研究资格筛查。最后，共有 219 名连续接受 ETV ( n = 146) 或 TDF ( n= 73) 在巴塞罗那临床肝癌 0 期或 A 期的 HBV 相关 HCC 的治愈性肝切除术后，通过倾向评分匹配 (PSM) (2:1) 分析和竞争风险分析进行了分析。比较 ETV 组和 TDF 组患者的 HCC 复发率和 OS。结果：中位随访52.2个月后，81例（37.0%）HCC复发，33例（15.1%）死亡，5例（2.3%）接受肝移植。与 ETV 治疗相比，TDF 治疗是 HCC 复发的独立保护因素（HR，1.687；95% CI，1.027–2.770，p= 0.039); 然而，死亡或肝移植的风险没有差异。竞争风险分析的结果相似。我们进一步发现，TDF 治疗与较低的晚期复发风险显着相关（HR，4.705；95% CI，1.763-12.558，p = 0.002），但与早期复发无关。结论：在因 HBV 相关的早期 HCC 接受根治性肝切除术的患者中，与 ETV 治疗相比，TDF 治疗与显着降低 HCC 复发风险相关，尤其是晚期复发风险。
肝癌