Background/Aims Tenofovir disoproxil fumarate (TDF) is potentially nephrotoxic in chronic hepatitis B patients. Hepatocellular carcinoma (HCC) patients treated using transarterial chemoembolization (TACE) are at an increased risk of renal injury. The aim of this study was to determine whether TDF is associated with more renal adverse events than entecavir (ETV) in HCC patients treated with TACE.
Methods In this retrospective single-center study, we selected 53 HCC patients who were treated with TDF from January 2012 to July 2013 and had their first TACE procedure in the same period. These patients were matched by age and sex to patients treated with ETV.
Results There were no significant differences in baseline characteristics, including HCC factors, and nephrotoxic drug use, between the two groups. The median follow-up period was 17.0 and 20.0 months for the TDF and ETV groups, respectively. There was no difference during the follow-up period between the TDF and ETV groups in the increase in creatinine over 0.5 mg/dL (17.0% and 17.0%, P=1.00, respectively) and the decrease in eGFR over 25% (43.4% and 41.5%, P=0.84, respectively). Multivariate analysis revealed that Child-Pugh class over B (hazard ratio [HR], 7.30; 95% confidence interval [CI] 2.79-19.10; P<0.01) was associated with increase in creatinine, and Child-Pugh class over B (HR, 82.74; 95% CI 12.31-555.83; P<0.01) and Barcelona-Clinic Liver Cancer stage over B (HR, 14.93; 95% CI 1.60-139.51; P=0.02) were associated with decrease in eGFR.
Conclusions TDF has comparable safety to that of ETV for HCC patients undergoing TACE.
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Big Data Information under Proportional Hazard Mathematical Model in Analysis of Hepatitis B Virus Infection Data of Patients with Interventional Liver Cancer through Antiviral Therapy of Entecavir Yichi Zhang, Shuai Zhao, Han Ding, Xiaoling Song, Huijie Miao, Xuya Cui, Jian Wang, Bing Han, Enas Abdulhay Journal of Healthcare Engineering.2021; 2021: 1. CrossRef
Recurrence of hepatocellular carcinoma (HCC) after hepatic resection is quite common. Peritoneal
recurrence has been considered incurable status and related to poor prognosis. Although
peritoneal metastasectomy is a therapeutic option for some selected patients with a few
peritoneal metastasis, the indication and therapeutic effect has not been clear. We report a
case of a 61-year-old man achieving complete remission of recurrent peritoneal metastasis after
repeated surgical resection by a multidisciplinary approach. Peritoneal metastasectomy might
be a therapeutic option for selected patients with localized oligonodular peritoneal metastasis.
Hepatocellular carcinoma (HCC) has poor prognosis, even after curative resection. Early
recurrence after curative treatment is a major cause of the poor prognosis. Pathologic factors
such as vessel invasion, satellite nodule, size of tumor and pathologic grade are prognostic
factors predicting early recurrence and poor prognosis. We share our experience of two case s which both showed early recurrence after curative hepatic resection, but eventually
demonstrated different prognosis. Since the most common cause of death after potentially
curative treatment is tumor recurrence, suppression of tumor recurrence might be linked
to survival gain. Currently, there is no adjuvant therapy for HCC endorsed by international
guidelines. However, recent studies have shown that antiviral treatment for hepatitis B virusrelated
HCC and immunotherapy using autologous cytokine-induced killer cell reduced
HCC recurrence. Further study is needed to select patients who will benefit from adjuvant
treatments.
Young Youn Cho, Jung Hee Kwon, Jeong-Hoon Lee, Jeong Min Lee, Jae Young Lee, Hyo-Choel Kim, Jin Wook Chung, Won-mook Choi, Eun Ju Cho, Yoon Jun Kim, Jung-Hwan Yoon, Chung Yong Kim, Hyo-Suk Lee
J Liver Cancer. 2015;15(1):19-29. Published online March 31, 2015
Background/Aims This study compared the outcomes of patients with small hepatocellular
carcinomas (HCCs) who were treated using transarterial chemoembolization (TACE) or
radiofrequency ablation (RFA). Methods This was a post-hoc analysis of a prospective study that evaluated the diagnostic
efficacy of magnetic resonance imaging (MRI) and computed tomography (CT). We analyzed
41 small hepatic nodules in 32 patients that showed typical radiologic hallmarks on both CT
and gadoxate-enhanced MRI (typical nodules) and 25 small hepatic nodules from 22 patients
that showed atypical radiologic hallmarks on CT and typical radiologic hallmarks on MRI
(discrepant nodules). Results There were no significant differences in the baseline characteristics of the patients
with typical and discrepant nodules. Complete response rates 1 month after TACE or RFA were
75.0% (18/24) and 94.1% (16/17; P=0.20), respectively, for the patients with typical nodules
and 58.8% (10/17) and 100% (8/8; P=0.05), respectively, for the patients with discrepant
nodules. Treatment failure rates after TACE or RFA were 33.3% (8/24) and 5.8% (1/17; P=0.15),
respectively, for the patients with typical nodules and 47.0% (8/17) and 0.0% (0/8; P=0.02),
respectively, for the patients with discrepant nodules. Among patients achieving complete
response, there were no significant differences in the risk of marginal recurrence. Conclusions RFA provided higher complete response rates and significantly lower treatment failure rates than TACE for patients with discrepant nodules of HCC. Therefore, a treatment
modality such as RFA may be preferable for small HCCs which show discrepancy on two
imaging modalities.