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Invited Critique
June 20, 2011

Will Adjuvant Antiviral Therapy Close the Outcome Gap Between Liver Transplantation and Resectional Therapy for Hepatitis B Virus–Associated Hepatocellular Cancer?: The Answer Is in Reach: Comment on “Impact of Antiviral Therapy on the Survival of Patients After Major Hepatectomy for Hepatitis B Virus–Related Hepatocellular Carcinoma”

Author Affiliations

Author Affiliation: Department of Surgery, The Johns Hopkins University, Baltimore, Maryland.

Arch Surg. 2011;146(6):682. doi:10.1001/archsurg.2011.113

The biology of hepatocellular carcinoma (HCC) is unique compared with other gastrointestinal tract cancers because most cases are caused by viral agents. It would follow that modulation of factors related to the infection has the potential to alter the natural history of HCC tumorigenesis. Indeed, the use of antiviral therapy in patients with chronic hepatitis B virus (HBV) infection in endemic populations of Asia has been shown to significantly reduce the risk of HCC.1 Despite this well-documented benefit, very little is known about the efficacy of antiviral therapy after a potentially curative resection of HBV-associated HCC. A recent meta-analysis2 identified only 2 studies on this subject and reported a favorable effect on survival, but not recurrence, with adjuvant therapy including antiviral treatments.

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