Efficacy of antiviral therapy with nucleotide/nucleoside analogs after curative treatment for patients with hepatitis B virus-related hepatocellular carcinoma: A systematic review and meta-analysis

SummaryBackground and objectiveA systematic review was conducted to evaluate whether or not antiviral therapy with nucleotide/nucleoside analogs (NA) have survival benefit for patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after curative treatment.MethodsAn electronic search of PubMed, EMBASE, and the Cochrane Library was performed to identify comparative studies in which the adjuvant effects of NA for patients with HBV-related HCC after curative treatment were evaluated. Primary outcome included survival rate, and secondary outcomes included tumor recurrence rate and side effects. Review Manager 5.1.6 software was used for meta-analysis.ResultsTwelve studies involving 6682 patients were included in our review. Meta-analysis results demonstrated that significant differences favoring the antiviral treatment groups were observed in 1-year survival rate (RR: 0.65, 95% CI: 0.53–0.79, P < 0.0001), 3-year survival rate (RR: 0.58, 95% CI: 0.46–0.74, P < 0.0001), and 5-year survival rate (RR: 0.56, 95% CI: 0.43–0.74, P < 0.0001) compared with the control group. After NA was administered, recurrence was significantly reduced after one year (RR: 0.77, 95% CI: 0.64–0.93, P = 0.006) and three years (RR: 0.81, 95% CI: 0.71–0.93, P = 0.002) but not after five years (RR: 0.94, 95% CI: 0.76–1.16, P = 0.55) compared with non-NA therapy.ConclusionCurrent evidence showed that antiviral therapy with NA could improve survival and reduce early recurrence for patients with HBV-related HCC after curative treatment. More high-quality prospective trials are expected.