Effects of Lamivudine on Outcome after Initial Treatment for Hepatocellular Carcinoma: A Meta-Analysis

Abstract

AIM: The beneficial effects of lamivudine on hepatitis B virus have been well recognized. After liver resection or radiofrequency ablation for HBV-related hepatocellular carcinoma, the role of lamivudine treatment is still controversial. The purpose of this paper is to assess the effect of lamivudine therapy after initial treatment for HCC on survival rate and HCC recurrence from available Cohort Studies. METHODS: Articles from PubMed/MEDLINE, EMBASE and the Cochrane database, including the non-English literature identified in these databases, were searched from January 1970 to November 2012. Studies comparing lamivudine treatment with no antiviral therapy after initial treatment for HCC were extracted only. The percentage of graft survival was extracted by “engauge digitizer” from survival curve if the data was not display directly. Meta-analysis was performed when at least three provided data. RESULTS: 10 articles were included in our study. Lamivudine treatment had significant effects on the incidence of HCC recurrence (RR=0.82, P=0.01) and 1-yr tumor free survival rates (HR=0.34, P<0.00001), but had no significant effect on 1-yr overall survival (HR=0.66, P=0.05). CONCLUSION: The results of this systematic review imply that lamivudine after initial treatment for HCC reduce recurrence rate and promoted tumor free survival rates, but it did not contribute to short-term overall survival.