A Meta-Analysis Of Antiviral Therapy With Nucletide Analogs After Curative Treatment Of Hepatitis B Vrus Related Hepatocellular Carcinoma

Background:Available published studies about the effect of antiviral therapy with nucleotide analogs (NAs) after curative treatment for patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) remains controversial.Aim:To evaluate the effect of adjuvant antiviral therapy with NAs on occurrence and survival after curative treatment of HBV-HCC.Methods:A systemic search of electronic databases (PubMed, EMBASE and Cochrane Library database) on the randomized and non-randomized trials about adjuvant antiviral therapy with NAs after curative treatment for patients with HBV-related HCC was performed. Screen the eligible literatures and extract data needed. The primary outcomes include HCC recurrence and mortality, and the second outcome is side effects of NAs during antiviral therapy. The pooled odds ratio (OR) and 95% confidence interval (CI) were calculated by RevMan 5.3.Results:14 literatures (2 randomized and 13 non-randomized trials, one study is a two-stage longitudinal with a non-randomized and randomized trials) with a total number of 6588patients were included: 1394 patients with NAs treatment and 5194 patients without NAs treatment(control group). Meta analysis results demonstrated that antiviral therapy with NAs could significantly decrease the HCC recurrence (OR=0.43,95%CI 0.33,0.56; P<0.00001) and the death of patients (OR=0.32,95%CI 0.24,0.43;P<0.00001) following curative treatment of HBV-HCC.Conclusion:Our meta-analysis indicates that adjuvant antiviral therapy with NAs may improve the prognosis of HBV related HCC after curative treatment. And NAs treatment should be considered for the patients following curative treatment.