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KMID : 1188320160100060939
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Gut and Liver
2016 Volume.10 No. 6 p.939 ~ p.947
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Lamivudine versus Entecavir for Newly Diagnosed Hepatitis B Virus-Related Hepatocellular Carcinoma
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Kim Jung-Hee
Sinn Dong-Hyun
Kim Kyung-A
Kim Hye-Seung
Gwak Geum-Youn
Paik Yong-Han
Choi Moon-Seok
Lee Joon-Hyeok
Koh Kwang-Cheol
Paik Seung-Woon
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Abstract
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Background/Aims: Antiviral therapy is a key component in the management of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) patients. However, whether the potent drug entecavir is more effective than a less potent drug, such as lamivudine, in HBV-related HCC is not clear.
Methods: A retrospective cohort of 451 newly diagnosed, HBV-related HCC patients without antiviral therapy at diagnosis, who started antiviral therapy with either entecavir (n=249) or lamivudine (n=202), were enrolled.
Results: The median survival was longer for the entecavir group than for the lamivudine group, and lamivudine use (vs entecavir) was an independent factor for mortality (hazard ratio [HR], 1.49; p=0.002). Lamivudine use (vs entecavir) was an independent risk factor for new-onset hepatic decompensation (HR, 1.67; p=0.010) in 318 patients without previous hepatic decompensation, and it was also an independent risk factor for recurrence after curative therapy (HR, 1.84; p=0.002) in 117 patients who received curative therapy. The findings were similar in a propensity score-matched cohort.
Conclusions: Overall survival, decompensation-free survival, and recurrence-free survival were better in the entecavir-treated patients than in the lamivudine treated-patients, indicating that the potent antiviral drug should be the preferred choice in HBV-related HCC patients.
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KEYWORD
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Antiviral agents, Hepatitis B, chronic, Carcinoma, hepatocellular, Potency, Survival
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