Page 53 - 台灣肝癌醫學冬季會手冊-1222-V3_Neat

day of NA administration and the survival time was confirmed through the end of 2018.

Results:

Patients with decompensated cirrhosis had significantly lower baseline serum HBV DNA levels

than compensated cirrhotic patients (4.98±1.91 vs. 5.67±1.26 log10 IU/ml, P=0.031). The mean

follow-up duration was 84 and 42 months in compensated cirrhotic and decompensated cirrhotic

patients (P<0.0001), respectively. For 59 decompensated cirrhotic patients, 27.1% (16/59) of patients

achieved CTP class A and 23.7% (14/59) showed improvement in the CTP score of ≧ 2 points after

2 years of NA treatment. The 1, 2 and 3-year cumulative survival rates were significantly higher in

compensated cirrhotic patients than those with decompensated cirrhosis (100%, 98.5%, 98.5% vs.

81.2%, 75.6%, 69.5%; P<0.0001). Multivariate analysis for risk factors of mortality in cirrhotic

patients showed that older age (hazard ratio: 3.28, 95% CI: 1.25-8.62, P=0.016) and decompensated

cirrhosis (hazard ratio: 8.30, 95% CI: 2.45-28.06, P=0.0007) were independently associated with

liver-related mortality. A total of 31 patients, 37.3% of compensated cirrhotic and 10.2% of

decompensated cirrhotic patients, developed HCC during the follow-up. The 1, 2 and 3-year

cumulative survival rates were not different between compensated cirrhotic patients with and without

HCC development (96%, 96%, 96% vs. 100%, 100%, 100%; P=0.577) (Figure 2). Similarly, the 1, 2

and 3-year cumulated survival rates were comparable between decompensated cirrhotic patients with

and without HCC development (83.3%, 83.3%, 66.7% vs. 81%, 74.7%, 69.8%; P=0.528). Among

patients with HCC, 70.9% were at the earlier stages of BCLC system, and 83.8% received potentially

curative treatment.

Conclusions:

Antiviral therapy improves liver function of HBV-related cirrhotic patients and provides a better

chance of curative treatment in those with HCC development. Decompensated cirrhosis is a risk

factor for liver-related mortality in this special clinical setting. (Word count:438)