Viral load is a significant prognostic factor for hepatitis B virus‐associated hepatocellular carcinoma

Publisher Website
Google Scholar
Abstract
BACKGROUND Hepatitis B virus (HBV) is closely linked to hepatocellular carcinoma (HCC). The objective of the current study was to identify the factors involved in the prognosis of patients with HBV‐associated HCC using multivariate analysis. METHODS The current study included 74 patients with HBV‐associated HCC who were admitted to Nagasaki University Hospital, Nagasaki, Japan, between 1983–1998. Of these, 13 patients underwent surgical tumor resection; 43 patients received nonsurgical treatment with transcatheter arterial embolization, percutaneous ethanol injection, or both; and 18 patients were followed without any active treatment. The significance of the patient's age; gender; history of blood transfusion; alcohol use; serum levels of alanine aminotransferase, α‐fetoprotein, and HBV‐DNA; number and size of liver tumors; clinical stage; and histologic diagnosis of HCC as prognostic factors was evaluated using univariate and multivariate analyses. RESULTS The 3‐year, 5‐year, and 10‐year postdiagnosis cumulative survival rates were 36%, 21%, and 17%, respectively. Multivariate analysis identified the level of serum HBV‐DNA and tumor size at diagnosis as independent and significant prognostic factors (P = 0.0022 and P = 0.0106, respectively). In addition, a low level of viremia was found to be associated with longer survival (P = 0.0057) even in patients who were negative for the hepatitis B e antigen. CONCLUSIONS The results of the current study suggest that viral load is a useful prognostic marker for HBV‐related HCC and that HCC patients with a less favorable course appear either to clear the virus poorly or to have a greater level of virus production. Cancer 2002;94:2663–8. © 2002 American Cancer Society. DOI 10.1002/cncr.10557