Influence of viral hepatitis status on prognosis in patients undergoing hepatic resection for hepatocellular carcinoma:
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WORLD JOURNAL OF SURGICAL ONCOLOGY
RESEARCH
Open Access
Influence of viral hepatitis status on prognosis in patients undergoing hepatic resection for hepatocellular carcinoma: a meta-analysis of observational studies Yanming Zhou1, Xiaoying Si2, Lupeng Wu1, Xu Su1, Bin Li1 and Zhiming Zhang3*
Abstract Background: The 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. Methods: A 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. Results: Twenty studies matched the selection criteria and reported on 4744 subjects, of whom 2008 in the HBVpositive (B-HCC) group, 2222 in the HCV-positive (C-HCC) group, and 514 in the hepatitis B- and C-negative (NBNCHCC). 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. Conclusions: Patients with positive serology for hepatitis B or C undergoing resection for HCC had a poor prognosis compared to patients with negative serology. Keywords: Hepatocellular carcinoma, Viral infection, Hepatitis B, Hepatitis C, Prognosis
Background Hepatocellular carcinoma (HCC) is the fifth most common cancer in the world, responsible for 500,000 deaths globally every year [1]. Chronic viral hepatitis and liver cirrhosis related to hepatitis B virus (HBV) and hepatitis C virus (HCV) infections represent the major known risk factors for HCC. 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]. Nevertheless, some patients with HCC are dually infected, whereas others are negative for both HBV and HCV [3-7]. * Correspondence: [email protected] 3 Cancer Center, the First affiliated Hospital of Xiamen University, Xiamen, China Full list of author information is available at the end of the article
Hepatic resection is widely accepted as the treatment of choice for HCC. With regard to surgery, it is important to determine whether or not the prognosis after resection differ according to the viral status. So far, the influence of viral status on prognosis for patients with HCC treated by resection remains controversial. For example, Yamanaka et al. [3] reported that the diseasefree and ove
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