https://scholars.lib.ntu.edu.tw/handle/123456789/568428
標題: | Association of adjuvant antiviral therapy with risk of cancer progression and deaths in patients with hepatitis-B-virus-related hepatocellular carcinoma following curative treatment: A nationwide cohort study | 作者: | Yeh Y.-C. CHUN-JEN LIU Kuo R.N. Lai C.-L. Shau W.-Y. PEI-JER CHEN Lai M.-S. |
公開日期: | 2014 | 出版社: | Public Library of Science | 卷: | 9 | 期: | 7 | 起(迄)頁: | e102051 | 來源出版物: | PLoS ONE | 摘要: | Background: Limited information about tumor status and the time at which antiviral therapy was initiated may have influenced effect estimation in previous research. The aim of this study was to investigate the effect of antiviral therapies on HBV-related HCC progression and deaths in patients receiving curative treatment based on clear clinical-pathological cancer status and the association of start time of adjuvant antiviral therapy initiation and outcomes. Methodology: A nationwide inception cohort study of newly diagnosed HCC patients who suffered from viral hepatitis B and received curative HCC therapy as the first course of treatment were identified from the Taiwan Cancer Registry between January 1, 2004, and December 31, 2009. Matched Cox proportional hazards models based on propensity score matching and incorporated time-varying exposure were used to estimate adjusted hazard ratios and 95% confidence intervals (CIs). Findings: Among 3,855 HCC patients with HBV, antiviral therapy was administered to 490 (12.7%) following curative treatment. Antiviral-treated patients had a higher percentage of young age, early stage, and smaller tumor size of HCC compared with untreated patients. After propensity score matching, treated patients demonstrated a higher risk of HCC progression (hazard ratio, 1.42; 95%CI, 1.20-1.69) and death from all causes (1.45; 1.15-1.82) than untreated patients. Similar results were also obtained in sub-cohort of patients who were alive with cancer-free status at least one year after receiving curative treatment and the sub-cohort of patients with liver resection. The interval length between initiation of antiviral therapy and first-line curative treatment did not show a significant association with all-cause mortality. Conclusions: This study found that adjuvant antiviral therapy did not reduce the risk of HCC progression or mortality in HBV-related HCC patients after cancer status adjusting. ? 2014 Yeh et al. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84904245871&doi=10.1371%2fjournal.pone.0102051&partnerID=40&md5=ff104fb8c11abe230aa0316ce63fb7b4 https://scholars.lib.ntu.edu.tw/handle/123456789/568428 |
ISSN: | 1932-6203 | DOI: | 10.1371/journal.pone.0102051 | SDG/關鍵字: | antineoplastic agent; lamivudine; telbivudine; antivirus agent; adult; age; aged; antiviral therapy; article; artificial embolism; cancer hormone therapy; cancer mortality; cancer radiotherapy; cancer registry; cancer risk; cancer staging; chemoembolization; cohort analysis; controlled study; disease association; female; hepatitis B; high risk patient; histopathology; human; liver cell carcinoma; liver resection; major clinical study; male; middle aged; propensity score; radiofrequency ablation; risk assessment; risk factor; risk reduction; sensitivity analysis; treatment outcome; tumor volume; young adult; adolescent; Carcinoma, Hepatocellular; comorbidity; complication; disease course; Hepatitis B virus; Hepatitis B, Chronic; Liver Neoplasms; mortality; pathology; register; Taiwan; very elderly; Adolescent; Adult; Aged; Aged, 80 and over; Antiviral Agents; Carcinoma, Hepatocellular; Cohort Studies; Comorbidity; Disease Progression; Female; Hepatitis B virus; Hepatitis B, Chronic; Humans; Liver Neoplasms; Male; Middle Aged; Neoplasm Staging; Registries; Risk Factors; Taiwan; Treatment Outcome; Tumor Burden; Young Adult |
顯示於: | 臨床醫學研究所 |
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