Apatinib treatment may improve survival outcomes of patients with hepatitis B virus-related sorafenib-resistant hepatocellular carcinoma

Aims: This study aimed to (a) assess the effectiveness and safety of apatinib as a subsequent treatment for patients with sorafenib-resistant hepatocellular carcinoma (HCC), and (b) identify the clinical factors influencing their treatment outcomes. Methods: The electronic medical records of consecutive patients with newly diagnosed advanced HCC treated with first-line sorafenib from 2015 to 2017 were retrospectively reviewed. Patients who were confirmed to have primary resistance to sorafenib were enrolled in this study. The outcomes of patients treated with apatinib were compared with those of patients who received supportive care. The primary endpoint was overall survival (OS). Results: A total of 92 patients with sorafenib-resistant advanced HCC (84 men and 8 women; mean age, 51.9 years) were included. All patients had an etiology of hepatitis B. The median OS in the overall cohort was 5.0 months [95% confidence interval (CI): 3.9, 6.0]. Of 92 patients, 58 (63.0%) were treated with apatinib, and 34 (37.0%) received supportive care. Apatinib treatment was associated with longer survival times than supportive care for patients with sorafenib-resistant advanced HCC (median OS: 7.0 versus 4.0 months, p < 0.001). The results of the multivariate analysis demonstrated that liver tumor load [hazard ratio (HR): 3.653, 95% CI: 2.047, 5.965, p < 0.001] and extrahepatic spread (HR: 0.303, 95% CI: 0.231, 0.778, p = 0.003) were independent predictors of OS after apatinib treatment. Conclusion: This study showed that subsequent apatinib treatment may improve survival outcomes compared with supportive care for patients with sorafenib-resistant, advanced hepatitis B virus (HBV)-related HCC, especially for patients who have a lower liver tumor load and extrahepatic spread.

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Association of type 2 diabetes mellitus with incidences of microvascular invasion and survival outcomes in hepatitis B virus-related hepatocellular carcinoma after liver resection: A multicenter study

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2021.08.010 ◽

2021 ◽

Author(s):

Xiu-Ping Zhang ◽

Zong-Tao Chai ◽

Jin-Kai Feng ◽

Hui-Min Zhu ◽

Fan Zhang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Hepatocellular Carcinoma ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Hepatitis B Virus ◽

Liver Resection ◽

Hepatitis B ◽

Survival Outcomes ◽

B Virus

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Lymphocyte to monocyte ratio and prognostic nutritional index predict survival outcomes of hepatitis B virus-associated hepatocellular carcinoma patients after curative hepatectomy

Journal of Surgical Oncology ◽

10.1002/jso.24297 ◽

2016 ◽

Vol 114 (2) ◽

pp. 202-210 ◽

Cited By ~ 27

Author(s):

Si-Jia Wu ◽

Yi-Xin Lin ◽

Hui Ye ◽

Fu-Yu Li ◽

Xian-Ze Xiong ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Hepatitis B Virus ◽

Hepatitis B ◽

Prognostic Nutritional Index ◽

Survival Outcomes ◽

Lymphocyte To Monocyte Ratio ◽

Nutritional Index ◽

B Virus ◽

Curative Hepatectomy

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Primary neuroendocrine liver tumor mimicking hepatocellular carcinoma in a patient with prior hepatitis B virus infection

Kanzo ◽

10.2957/kanzo.61.116 ◽

2020 ◽

Vol 61 (3) ◽

pp. 116-121

Author(s):

Yoshinari Ozawa ◽

Yutaka Midorikawa ◽

Nao Yoshida ◽

Kenichi Teramoto ◽

Rempei Yagi ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Hepatitis B Virus ◽

Virus Infection ◽

Hepatitis B ◽

Liver Tumor ◽

Hepatitis B Virus Infection ◽

B Virus

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Development of Models to Predict Postoperative Complications for Hepatitis B Virus-Related Hepatocellular Carcinoma

Frontiers in Oncology ◽

10.3389/fonc.2021.717826 ◽

2021 ◽

Vol 11 ◽

Author(s):

Mingyang Bao ◽

Qiuyu Zhu ◽

Tuerganaili Aji ◽

Shuyao Wei ◽

Talaiti Tuergan ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Hepatitis B Virus ◽

Postoperative Complications ◽

Hepatitis B ◽

Liver Tumor ◽

Multivariable Analysis ◽

Hbv Infection ◽

Thrombin Time ◽

Chronic Hepatitis B Virus ◽

B Virus

BackgroundSurgical treatment remains the best option for patients with hepatocellular carcinoma (HCC) caused by chronic hepatitis B virus (HBV) infection. However, there is no optimal tool based on readily accessible clinical parameters to predict postoperative complications. Herein, our study aimed to develop models that permitted risk of severe complications to be assessed before and after liver resection based on conventional variables.MethodsA total of 1,047 patients treated by hepatectomy for HCC with HBV infection at three different centers were recruited retrospectively between July 1, 2014, and July 1, 2018. All surgical complications were recorded and scored by the Comprehensive Complication Index (CCI). A CCI ≥26.2 was used as a threshold to define patients with severe complications. We built two models for the CCI, one using preoperative and one using preoperative and postoperative data. Besides, CCI and other potentially relevant factors were evaluated for their ability to predict early recurrence and metastasis. All the findings were internally validated in the Hangzhou cohort and then externally validated in the Lanzhou and Urumqi cohorts.ResultsMultivariable analysis identified National Nosocomial Infections Surveillance (NNIS) index, tumor number, gamma-glutamyltransferase (GGT), total cholesterol (TC), potassium, and thrombin time as the key preoperative parameters related to perioperative complications. The nomogram based on the preoperative model [preoperative CCI After Surgery for Liver tumor (CCIASL-pre)] showed good discriminatory performance internally and externally. A more accurate model [postoperative CCI After Surgery for Liver tumor (CCIASL-post)] was established, combined with the other four postoperative predictors including leukocyte count, basophil count, erythrocyte count, and total bilirubin level. No significant association was observed between CCI and long-term complications.ConclusionBased on the widely available clinical data, statistical models were established to predict the complications after hepatectomy in patients with HBV infection. All the findings were extensively validated and shown to be applicable nationwide. Such models could be used as guidelines for surveillance follow-up and the design of post-resection adjuvant therapy.

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Role of environmental factors in the etiology of hepatocellular carcinoma

Orvosi Hetilap ◽

10.1556/oh.2010.28913 ◽

2010 ◽

Vol 151 (28) ◽

pp. 1132-1136 ◽

Cited By ~ 7

Author(s):

István Tornai

Keyword(s):

Hepatocellular Carcinoma ◽

Hepatitis B Virus ◽

Environmental Factors ◽

Hepatitis B ◽

Hepatitis A ◽

Virus Hepatitis ◽

B Virus

A krónikus vírushepatitisek jelentik ma a legismertebb okokat a hepatocellularis carcinoma (HCC) kialakulásában. A krónikus B- és C-vírus-hepatitis a májrákok körülbelül 40-50%-át okozza. A nyugati típusú társadalmakban a HCC előfordulása folyamatosan növekvő tendenciát mutat. Az alkohol számít a környezeti tényezők közül a legfontosabbnak, bár az alkoholfogyasztás a legtöbb országban csökken. Ez aláhúzza az egyéb környezeti tényezők fontosságát is. Az elfogyasztott alkoholmennyiséggel egyenes arányban növekszik a cirrhosis és a következményes HCC gyakorisága nőkben és férfiakban egyaránt. A kémiai anyagok közül a legismertebb a Kínában és Afrikában elterjedt aflatoxin, amely a gabonaféléket szennyező mycotoxin. Hasonló területeken endémiás, mint a hepatitis B-vírus, együtt szinergista hatást fejtenek ki. A dohányzás is egyértelműen bizonyított hepatocarcinogen hatással rendelkezik. Ez is jelentősen fokozódik, ha alkoholfogyasztással vagy vírushepatitisszel társul. Társadalmilag talán a legfontosabb az elhízás, a következményes nem alkoholos zsírmáj, illetve steatohepatitis és a 2-es típusú cukorbetegség, amelyek prevalenciája egyre fokozódik. Feltehetően ezek állnak a növekvő HCC-gyakoriság hátterében. Az inzulinrezisztencia és az oxidatív stressz képezik a legfontosabb patogenetikai lépéseket a májsejtkárosodásban. További fontos rizikótényező az orális fogamzásgátlók elterjedt használata. Egyes foglalkozások esetén a tartós szervesoldószer-expozíció is növeli a HCC rizikóját. Védelmet jelenthetnek az antioxidánsok, a szelén, a gyógyszerek közül a statinok és a feketekávé-fogyasztás.

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