Background: Surgical outcome of patients with hepatocellular carcinoma (HCC) in relation to the serum hepatitis B envelope (HBe) has not been clarified in detail.
Methods: We retrospectively studied 732 patients with HCC within the Milan criteria who underwent hepatectomy from 1991 through 2005. Serum hepatitis B surface antigen (HBs-Ag) and hepatitis C virus (HCV) antibody were routinely performed preoperatively, and 92 patients were only positive for HBs-Ag. Serum HBe antibody (HBe-Ab) was further examined, and surgical outcomes after hepatectomy were compared with those of 70 patients who were positive for HBe-Ab and 15 patients who were negative for HBe-Ab.
Results: The 5- and 10-year survival rates were significantly greater in patients who were positive for HBe-Ab (90% and 80%, respectively) than in patients who were negative for HBe-Ab (61% and 37%: P = 0.0004, respectively). The 5-year recurrence-free survival rate was significantly greater in patients who were positive for HBe-Ab (53%) than in patients who were negative for HBe-Ab (21%: P = 0.0054). Multivariate analysis showed that positive HBe-Ab was an independent prognostic factor for survival (P = 0.0045) and recurrence-free survival (P = 0.004).
Conclusions: Favorable long-term surgical outcomes were achieved in patients with HCC within the Milan criteria who were positive for HBe-Ab.
(c) 2010 Wiley-Liss, Inc.