Abstract
BackgroundThe influence of viral hepatitis status on prognosis in patients undergoing hepatic resection for hepatocellular carcinoma (HCC) remains a matter of debate. This study is a meta-analysis of the available evidence.MethodsA literature search was performed to identify comparative studies reporting postoperative survival of HCC in different types of viral hepatitis. Pooled odds ratios (OR) and weighted mean differences (WMD with 95% confidence intervals (95% CI) were calculated using either the fixed effects model or random effects model.ResultsTwenty studies matched the selection criteria and reported on 4744 subjects, of whom 2008 in the HBV-positive (B-HCC) group, 2222 in the HCV-positive (C-HCC) group, and 514 in the hepatitis B- and C-negative (NBNC-HCC). Meta-analysis showed that patients with HBV or HCV infection had a worse 5-year disease-free survival when compared to patients with NBNC-HCC (respectively: OR: 0.39, 95% CI: 0.28 to 0.53, P < 0.001; WMD: 0.37, 95% CI: 0.22 to 0.64, P < 0.001). There was a tendency toward higher 5-year overall survival rates in the NBNC-HCC group compared to those in the other two groups, although these differences were not statistically significant. Both the 5-year overall survival and disease-free survival were not different among the B-HCC and C-HCC groups.ConclusionsPatients with positive serology for hepatitis B or C undergoing resection for HCC had a poor prognosis compared to patients with negative serology.
Highlights
The influence of viral hepatitis status on prognosis in patients undergoing hepatic resection for hepatocellular carcinoma (HCC) remains a matter of debate
A review of the literature reveals that 75% to 80% of cases of HCC are attributable to persistent viral infections with either hepatitis B virus (HBV) (50%-55%) or hepatitis C virus (HCV) (25%-30%) [2]
4744 patients were included in the meta-analysis, of whom 2008 in the B-HCC group, 2222 in the C-HCC group, and 514 in the NBNC-HCC group
Summary
The influence of viral hepatitis status on prognosis in patients undergoing hepatic resection for hepatocellular carcinoma (HCC) remains a matter of debate. A review of the literature reveals that 75% to 80% of cases of HCC are attributable to persistent viral infections with either HBV (50%-55%) or HCV (25%-30%) [2]. Some patients with HCC are dually infected, whereas others are negative for both HBV and HCV [3,4,5,6,7]. The influence of viral status on prognosis for patients with HCC treated by resection remains controversial. Yamanaka et al [3] reported that the diseasefree and overall survival rates of hepatitis B- and Cnegative group were better than those of viral infections groups. Pawlik et al [5] reported that the presence of viral hepatitis did not significantly affect the survival rate
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