Abstract

Aims. To understand the feasibility and efficacy of treatment with SAMe in patients with hepatitis B-related HCC with different Barcelona Clinic Liver Cancer (BCLC) stages. Methods. We retrospectively enrolled 697 patients with BCLC early-stage (stages 0-A) and advanced-stage (stages B-C) HCC who underwent SAMe therapy (354 cases) or no SAMe therapy (343 cases). The baseline characteristics, postoperative recoveries, and 24-month overall survival rates of the patients in the 2 groups were compared. Cox regression model analysis was performed to confirm the independent variables influencing the survival rate. Results. For patients in the early-stage (BCLC stages A1–A4) group, little benefit of SAMe therapy was observed. For advanced-stage (BCLC B-C) patients, SAMe therapy reduced alanine aminotransferase (ALT) and aspartate transaminase (AST) levels and effectively delayed the recurrence time and enhanced the 24-month survival rate. Cox regression model analysis in the advanced-stage group revealed that treatment with SAMe, preoperative viral load, and Child-Pugh grade were independent variables influencing survival time. Conclusion. SAMe therapy exhibited protective and therapeutic efficacy for BCLC advanced-stage HBV-related HCC patients. And the efficacy of SAMe therapy should be further explored in randomized prospective clinical trials.

Highlights

  • Hepatocellular carcinoma (HCC) is among the most common cancer types and causes of cancer-related mortality worldwide [1]

  • Nearly 50% of all HCC cases are attributable to chronic hepatitis B virus (HBV) infection [2]

  • No Barcelona Clinic Liver Cancer (BCLC) stage 0 or stage D patients were included in this study

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Summary

Introduction

Hepatocellular carcinoma (HCC) is among the most common cancer types and causes of cancer-related mortality worldwide [1]. HCC nearly always develops within the background of chronic liver disease. Nearly 50% of all HCC cases are attributable to chronic hepatitis B virus (HBV) infection [2]. Surgery remains the most effective treatment with curative potential. Only approximately 10 to 20% of patients with HCC are eligible for surgical intervention. Therapies such as transcatheter arterial chemoembolization (TACE) and interferon alpha may prolong survival in some patients. The response to these treatments is often not satisfactory because of the high rate of relapse. Novel drugs that can induce synergistic therapeutic effects in HBV-related HCC patients are urgently needed

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