Liu HM, Zhang X, Huang HY, Sun JM, Tong QD. Comparative impact of antiviral therapies on postoperative recurrence risk in patients with hepatitis B virus-related hepatocellular carcinoma. World J Gastrointest Oncol 2025; 17(9): 106297 [DOI: 10.4251/wjgo.v17.i9.106297]
Corresponding Author of This Article
Qing-Dong Tong, MD, Chief Physician, Department of Infectious Diseases, The Second Hospital of Longyan, No. 153 Dongxing Road, Xinluo District, Longyan 364000, Fujian Province, China. 13616906527@163.com
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Hua-Mei Liu, Xin Zhang, Hang-Ying Huang, Jia-Min Sun, Qing-Dong Tong, Department of Infectious Diseases, The Second Hospital of Longyan, Longyan 364000, Fujian Province, China
Author contributions: Liu HM, Zhang X, Huang HY, Sun JM, Tong QD contributed equally to this work; Liu HM, Zhang X, and Huang HY designed the research study; Sun JM and Tong QD performed the primary literature search and data extraction; Liu HM analyzed the data and drafted the manuscript; Sun JM and Tong QD revised the manuscript for important intellectual content; and all authors read and approved the final version submitted for publication.
Institutional review board statement: The study was reviewed and approved by the Second Hospital of Longyan Institutional Review Board, No. LYEY-KY-2025-004.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at 13616906527@163.com. Participants gave informed consent for data sharing.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qing-Dong Tong, MD, Chief Physician, Department of Infectious Diseases, The Second Hospital of Longyan, No. 153 Dongxing Road, Xinluo District, Longyan 364000, Fujian Province, China. 13616906527@163.com
Received: March 21, 2025 Revised: April 15, 2025 Accepted: July 30, 2025 Published online: September 15, 2025 Processing time: 177 Days and 17.3 Hours
Abstract
BACKGROUND
Entecavir (ETV) and tenofovir fumarate (TDF) are recommended first-line agents for the treatment of chronic hepatitis B virus (HBV) infection. However, the effect of these 2 antiviral agents on the risk for recurrence of HBV-associated hepatocellular carcinoma (HCC) after radical hepatectomy remains controversial.
AIM
To compare the effect of TDF vs ETV on the risk for HCC recurrence after radical surgery for HBV-related HCC.
METHODS
Data from consecutive patients, who received TDF or ETV after radical hepatectomy for HBV-related HCC and admitted to the Second Hospital of Longyan between December 2018 and December 2023, were retrospectively analyzed. Based on treatment method and propensity score matching (PSM), data from 100 patients were included, with 50 in each of the TDF and ETV groups, respectively. The baseline characteristics of the 2 groups were analyzed, and the risk for HCC recurrence was compared between the groups.
RESULTS
The median follow-up for 100 patients [median age, 61 years; 84 male (84%)] who underwent radical resection for HBV-related HCC - Barcelona Clinic Liver Cancer stage 0 [n = 16 (16%)], stage A [n = 61 (61%)] - was 29 months (range, 12-60 months); the median tumor size was 3.0 cm (range, 2.1-4.3 cm). Sixty-eight (68%) patients exhibited HBV-DNA levels > 1000 IU/mL. Twenty-two (22%) patients tested positive for hepatitis B e antigen, in whom the HCC recurrence rate was 59.1% (13/22). After PSM, HCC recurrence rates in the ETV and TDF groups after hepatectomy were 66% (n = 33) and 42% (n = 21), respectively (P = 0.016), and cumulative recurrence rates at 1, 3, and 5 years were 26%, 58%, and 66%, and 18%, 38%, and 42%, respectively (P = 0.045).
CONCLUSION
TDF treatment is associated with a lower risk for HCC-related outcomes than that for ETV in patients with HBV-associated HCC after curative therapy.
Core Tip: This study compared the recurrence rate of hepatocellular carcinoma (HCC) after radical resection of HCC in patients treated with entecavir (ETV) or tenofovir fumarate (TDF) after propensity score matching. Results revealed that HCC recurrence was observed in 33 (66.0%) patients in the ETV group and 21 (42.0%) in the TDF group, and the risk for HCC recurrence was lower in the TDF group than in the ETV group (P = 0.016). The cumulative recurrence rates of HCC at 1, 3, and 5 years in the ETV and TDF groups were 26.0%, 58.0%, and 66.0%, and 18.0%, 38.0%, and 42.0%, respectively (P = 0.045).
