High HBV Viral Load at Surgery Tied to Liver Cancer Return

In patients undergoing liver resection for hepatocellular carcinoma related to hepatitis B virus (HBV) infection, viral load at the time of surgery is predictive of hepatoma recurrence, according to Chinese researchers.

"High hepatitis B viral load," senior investigator Dr. Man-Fung Yuen told Reuters Health, "is associated with a higher chance of HCC recurrence after surgical resection. Use of an antiviral agent after surgery may reduce this chance."

Dr. Yuen and colleagues at the University of Hong Kong followed 72 patients for a median of 18.9 months after surgery. Thirty patients developed tumor recurrence.

In the July issue of the American Journal of Gastroenterology, the researchers report that an HBV viral load of more than 2000 IU/mL at the time of surgery was "the most important correctable risk factor" for tumor recurrence on multivariate analysis (odds ratio, 22.3).

Other baseline factors that were independently associated with recurrence were tumor size greater than 5 cm, alpha fetoprotein level greater than 1,000 ng/mL, and age greater than 60.

"Initiation of antiviral therapy for patients with HBV DNA levels above 2,000 IU/ the time of tumor resection and close monitoring of the subsequent HBV viral load may be able to decrease tumor recurrence in these patients," the investigators conclude.

Am J Gastroenterol 2008;103:1663-1673.

Reviewed by Ramaz Mitaishvili, MD

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