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2024 ; 16
(7
): 2106-2118
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English Wikipedia
Association of preoperative antiviral treatment with incidences of
post-hepatectomy liver failure in hepatitis B virus-related hepatocellular
carcinoma
#MMPMID39087126
Wang X
; Lin ZY
; Zhou Y
; Zhong Q
; Li ZR
; Lin XX
; Hu MG
; He KL
World J Gastrointest Surg
2024[Jul]; 16
(7
): 2106-2118
PMID39087126
show ga
BACKGROUND: Post-hepatectomy liver failure (PHLF) is a common consequence of
radical partial hepatectomy in hepatocellular carcinoma (HCC). AIMS: To
investigate the relationship between preoperative antiviral therapy and PHLF, as
well as assess the potential efficacy of hepatitis B virus (HBV) DNA level in
predicting PHLF. METHODS: A retrospective study was performed involving 1301 HCC
patients with HBV who underwent radical hepatectomy. Receiver operating
characteristic (ROC) analysis was used to assess the capacity of HBV DNA to
predict PHLF and establish the optimal cutoff value for subsequent analyses.
Logistic regression analyses were performed to assess the independent risk
factors of PHLF. The increase in the area under the ROC curve, categorical net
reclassification improvement (NRI), and integrated discrimination improvement
(IDI) were used to quantify the efficacy of HBV DNA level for predicting PHLF.
The P < 0.05 was considered statistically significant. RESULTS: Logistic
regression analyses showed that preoperative antiviral therapy was independently
associated with a reduced risk of PHLF (P < 0.05). HBV DNA level with an optimal
cutoff value of 269 IU/mL (P < 0.001) was an independent risk factor of PHLF. All
the reference models by adding the variable of HBV DNA level had an improvement
in area under the curve, categorical NRI, and IDI, particularly for the
fibrosis-4 model, with values of 0.729 (95%CI: 0.705-0.754), 1.382 (95%CI:
1.341-1.423), and 0.112 (95%CI: 0.110-0.114), respectively. All the above
findings were statistically significant. CONCLUSION: In summary, preoperative
antiviral treatment can reduce the incidence of PHLF, whereas an increased
preoperative HBV DNA level has a correlative relationship with an increased
susceptibility to PHLF.