Detailed Abstract
[Liver Poster Presentation 7 - Liver (Transplantation)]
[LV PP 7-1] Entecavir Versus Tenofovir On The Recurrence Of Hepatitis B Virus Related Hepatocellular Carcinoma After Liver Transplantation: A Korean Nation-wide Study
Deok-Gie KIM1 , Jae Geun LEE*1 , Myoung Soo KIM1 , Dong Jin JOO1
1 Surgery, Yonsei University College Of Medicine, REPUBLIC OF KOREA
Background : Tenofovir disoproxil fumarate (TDF) has been reported as having more potent anti-tumor effect than entecavir (ETV) in patients with chronic hepatitis B virus (HBV) infection, although there was discrepancy among studies. However, comparison of the two drugs regarding hepatocellular carcinoma (HCC) recurrence has not yet been evaluated in LT recipients.
Methods : We performed multicentric observational study using data of patients who underwent liver transplantation for HBV-related HCC. Patients were divided into two groups according to the type of oral nucleos(t)ide as an anti-HBV prophylaxis the; ETV (n=393) and the TDF group (n=452). Five-year outcomes were compared in the original cohort as well as using inverse probability treatment weight method followed by analyses with various Cox models.
Results : In the original cohort, HCC-recurrence free survival (84.1% for the ETV group vs. 84.2% for the TDF group, P=0.982), overall survival (93.5% vs. 94.9%, P=0.480), and HBV-recurrence free survival (97.3% vs. 96.4%, P=0.240) were similar between the ETV and the TDF groups. IPTW analyses showed similar trend in all outcomes. In various Cox models such as covariate adjusted, propensity-score weighted, center effect adjusted, competing risk regression, and time dependent covariates adjusted models, ETV or TDF did not showed significant association with HCC recurrence and overall death. In various subgroups categorized by factors associated with HCC burden, such as Milan, Up-to-7, French risk score, pretransplant loco-regional treatment, and salvage LT, ETV or TDF were not related with HCC recurrence or overall death.
Conclusions : In LT recipients from HBV-related HCC, neither ETV nor TDF showed significant superiority over HCC recurrence and overall death.
Methods : We performed multicentric observational study using data of patients who underwent liver transplantation for HBV-related HCC. Patients were divided into two groups according to the type of oral nucleos(t)ide as an anti-HBV prophylaxis the; ETV (n=393) and the TDF group (n=452). Five-year outcomes were compared in the original cohort as well as using inverse probability treatment weight method followed by analyses with various Cox models.
Results : In the original cohort, HCC-recurrence free survival (84.1% for the ETV group vs. 84.2% for the TDF group, P=0.982), overall survival (93.5% vs. 94.9%, P=0.480), and HBV-recurrence free survival (97.3% vs. 96.4%, P=0.240) were similar between the ETV and the TDF groups. IPTW analyses showed similar trend in all outcomes. In various Cox models such as covariate adjusted, propensity-score weighted, center effect adjusted, competing risk regression, and time dependent covariates adjusted models, ETV or TDF did not showed significant association with HCC recurrence and overall death. In various subgroups categorized by factors associated with HCC burden, such as Milan, Up-to-7, French risk score, pretransplant loco-regional treatment, and salvage LT, ETV or TDF were not related with HCC recurrence or overall death.
Conclusions : In LT recipients from HBV-related HCC, neither ETV nor TDF showed significant superiority over HCC recurrence and overall death.
SESSION
Liver Poster Presentation 7
Poster Presentation 3/24/2023 2:50 PM - 3:50 PM