Treatments of Hepatocellular Carcinoma Patients with Hepatitis B Virus Infection: Treat HBV-related HCC

Charing Ching-Ning Chong; Grace Lai-Hung Wong; Charing Ching-Ning Chong; Grace Lai-Hung Wong

doi:10.3934/medsci.2016.1.162

AIMS Medical Science

2016, Volume 3, Issue 1: 162-178. doi: 10.3934/medsci.2016.1.162

Previous Article Next Article

Review

Treatments of Hepatocellular Carcinoma Patients with Hepatitis B Virus Infection: Treat HBV-related HCC

Charing Ching-Ning Chong ^1,2,
Grace Lai-Hung Wong ^{1,3,4
,
,}

1.
Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
2.
Department of Surgery, The Chinese University of Hong Kong, Hong Kong
3.
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
4.
State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong

Received: 22 October 2015 Accepted: 16 March 2016 Published: 18 March 2016

There have been major advances recently on the therapeutic approaches of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Surgical treatments are the key curative treatments of HCC, whereas local ablative treatments may also achieve clinical remission in selected cases. Trans-arterial locoregional therapies are regarded as palliative but still lead to improved survival. There have been major breakthroughs in the systemic therapies for HCC. The first marketed targeted therapy, sorafenib, was shown to improve survival in patients with advanced HCC. Studies on other targeted therapies also showed promising results. Suppressing HBV with effective antiviral treatment would also benefit HCC patients by reducing recurrence and improving liver function.
- hepatitis B,
- HBV DNA,
- hepatocellular carcinoma,
- cirrhosis,
- lamivudine,
- entecavir,
- tenofovir,
- interferon,
- sorafenib,
- sirolimus
Citation: Charing Ching-Ning Chong, Grace Lai-Hung Wong. Treatments of Hepatocellular Carcinoma Patients with Hepatitis B Virus Infection: Treat HBV-related HCC[J]. AIMS Medical Science, 2016, 3(1): 162-178. doi: 10.3934/medsci.2016.1.162

Related Papers:

Abstract

There have been major advances recently on the therapeutic approaches of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Surgical treatments are the key curative treatments of HCC, whereas local ablative treatments may also achieve clinical remission in selected cases. Trans-arterial locoregional therapies are regarded as palliative but still lead to improved survival. There have been major breakthroughs in the systemic therapies for HCC. The first marketed targeted therapy, sorafenib, was shown to improve survival in patients with advanced HCC. Studies on other targeted therapies also showed promising results. Suppressing HBV with effective antiviral treatment would also benefit HCC patients by reducing recurrence and improving liver function.

References

[1]	Trepo C, Chan HL, Lok A (2014) Hepatitis B virus infection. Lancet 384: 2053-2063.
[2]	Parkin DM, Bray F, Ferlay J, et al. (2005) Global cancer statistics, 2002. CA Cancer J Clin 55: 74-108. doi: 10.3322/canjclin.55.2.74
[3]	El-Serag HB (2012) Epidemiology of viral hepatitis and hepatocellular carcinoma. Gastroenterology 142: 1264-1273 e1. doi: 10.1053/j.gastro.2011.12.061
[4]	Lim KC, Chow PK, Allen JC, et al. (2012) Systematic review of outcomes of liver resection for early hepatocellular carcinoma within the Milan criteria. Br J Surg 99: 1622-1629.
[5]	Yamazaki S, Takayama T (2008) Surgical treatment of hepatocellular carcinoma: evidence-based outcomes. World J Gastroenterol 14: 685-692. doi: 10.3748/wjg.14.685
[6]	Cescon M, Colecchia A, Cucchetti A, et al. (2012) Value of transient elastography measured with FibroScan in predicting the outcome of hepatic resection for hepatocellular carcinoma. Ann Surg 256: 706-712
[7]	Child CG, Turcotte JG (1964) Surgery and portal hypertension. Major Probl Clin Surg 1: 1-85.
[8]	Pugh RN, Murray-Lyon IM, Dawson JL, et al. (1973) Transection of the oesophagus for bleeding oesophageal varices. Br J Surg 60: 646-649. doi: 10.1002/bjs.1800600817
[9]	Fung J, Poon RT, Yu WC, et al. (2013) Use of liver stiffness measurement for liver resection surgery: correlation with indocyanine green clearance testing and post-operative outcome. PLoS One 8: e72306. doi: 10.1371/journal.pone.0072306
[10]	Wong JS, Wong GL, Chan AW, et al. (2012) Liver stiffness measurement by transient elastography as a predictor on post-hepatectomy outcomes. Ann Surg.
[11]	Ribero D, Chun YS, Vauthey JN (2008) Standardized liver volumetry for portal vein embolization. Semin Intervent Radiol 25:104-109. doi: 10.1055/s-2008-1076681
[12]	van Lienden KP, van den Esschert JW, de Graaf W, et al. (2013) Portal vein embolization before liver resection: a systematic review. Cardiovasc Intervent Radiol 36: 25-34.
[13]	Abulkhir A, Limongelli P, Healey AJ, et al. (2008) Preoperative portal vein embolization for major liver resection: a meta-analysis. Ann Surg 247: 49-57.
[14]	Cheung TT, Poon RT, Yuen WK, et al. (2013) Long-term survival analysis of pure laparoscopic versus open hepatectomy for hepatocellular carcinoma in patients with cirrhosis: a single-center experience. Ann Surg 257: 506-511. doi: 10.1097/SLA.0b013e31827b947a
[15]	Lee KF, Chong CN, Wong J, et al. (2011) Long-term results of laparoscopic hepatectomy versus open hepatectomy for hepatocellular carcinoma: a case-matched analysis. World J Surg 35: 2268-2274. doi: 10.1007/s00268-011-1212-6
[16]	Wakabayashi G, Cherqui D, Geller DA, et al. (2015) Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka. Ann Surg 261: 619-629.
[17]	Mazzaferro V, Regalia E, Doci R, et al. (1996) Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 334: 693-699.
[18]	Mazzaferro V, Bhoori S, Sposito C, et al. (2011) Milan criteria in liver transplantation for hepatocellular carcinoma: an evidence-based analysis of 15 years of experience. Liver Transpl 17 Suppl 2: S44-57.
[19]	Figueras J, Ibanez L, Ramos E, et al. (2001) Selection criteria for liver transplantation in early-stage hepatocellular carcinoma with cirrhosis: results of a multicenter study. Liver Transpl 7: 877-883.
[20]	Llovet JM, Fuster J, Bruix J, et al. (2004) The Barcelona approach: diagnosis, staging, and treatment of hepatocellular carcinoma. Liver Transpl 10: S115-120.
[21]	de Villa V, Lo CM (2007) Liver transplantation for hepatocellular carcinoma in Asia. Oncologist 12: 1321-1231.
[22]	Akamatsu N, Sugawara Y, Kokudo N (2014) Living donor liver transplantation for patients with hepatocellular carcinoma. Liver Cancer 3: 108-118. doi: 10.1159/000343866
[23]	Akamatsu N, Sugawara Y, Kokudo N (2014) Living-donor vs deceased-donor liver transplantation for patients with hepatocellular carcinoma. World J Hepatol 6: 626-631.
[24]	Sarasin FP, Majno PE, Llovet JM, et al. (2001) Living donor liver transplantation for early hepatocellular carcinoma: A life-expectancy and cost-effectiveness perspective. Hepatology 33: 1073-1079.
[25]	Di Sandro S, Slim AO, Giacomoni A, et al. (2009) Living donor liver transplantation for hepatocellular carcinoma: long-term results compared with deceased donor liver transplantation. Transplant Proc 41: 1283-1285. doi: 10.1016/j.transproceed.2009.03.022
[26]	Hwang S, Lee SG, Joh JW, et al. (2005) Liver transplantation for adult patients with hepatocellular carcinoma in Korea: comparison between cadaveric donor and living donor liver transplantations. Liver Transpl 11: 1265-1272. doi: 10.1002/lt.20549
[27]	Lo CM, Fan ST, Liu CL, et al. (2007) Living donor versus deceased donor liver transplantation for early irresectable hepatocellular carcinoma. Br J Surg 94: 78-86. doi: 10.1002/bjs.5528
[28]	Curley SA, Izzo F, Ellis LM, et al. (2000) Radiofrequency ablation of hepatocellular cancer in 110 patients with cirrhosis. Ann Surg 232: 381-391. doi: 10.1097/00000658-200009000-00010
[29]	Ng KK, Poon RT (2005) Radiofrequency ablation for malignant liver tumor. Surg Oncol 14: 41-52.
[30]	Wong J, Lee KF, Lee PS, et al. (2009) Radiofrequency ablation for 110 malignant liver tumours: preliminary results on percutaneous and surgical approaches. Asian J Surg 32: 13-20. doi: 10.1016/S1015-9584(09)60003-8
[31]	Yokoyama T, Egami K, Miyamoto M, et al. (2003) Percutaneous and laparoscopic approaches of radiofrequency ablation treatment for liver cancer. J Hepatobiliary Pancreat Surg 10: 425-427. doi: 10.1007/s00534-002-0830-7
[32]	Brunello F, Veltri A, Carucci P, et al. (2008) Radiofrequency ablation versus ethanol injection for early hepatocellular carcinoma: A randomized controlled trial. Scand J Gastroenterol 43: 727-735.
[33]	Livraghi T, Meloni F, Di Stasi M, et al. (2008) Sustained complete response and complications rates after radiofrequency ablation of very early hepatocellular carcinoma in cirrhosis: Is resection still the treatment of choice? Hepatology 47: 82-89.
[34]	Lencioni R, Cioni D, Crocetti L, et al. (2005) Early-stage hepatocellular carcinoma in patients with cirrhosis: long-term results of percutaneous image-guided radiofrequency ablation. Radiology 234: 961-967. doi: 10.1148/radiol.2343040350
[35]	Llovet JM, Bruix J (2008) Novel advancements in the management of hepatocellular carcinoma in 2008. J Hepatol 48 Suppl 1: S20-37.
[36]	Liang P, Wang Y (2007) Microwave ablation of hepatocellular carcinoma. Oncology 72 Suppl 1: 124-131.
[37]	Ong SL, Gravante G, Metcalfe MS, et al. (2009) Efficacy and safety of microwave ablation for primary and secondary liver malignancies: a systematic review. Eur J Gastroenterol Hepatol 21: 599-605.
[38]	Chinnaratha MA, Chuang MA, Fraser RJ, et al. (2015) Percutaneous thermal ablation for primary hepatocellular carcinoma: A systematic review and meta-analysis. J Gastroenterol Hepatol.
[39]	Lloyd DM, Lau KN, Welsh F, et al. (2011) International multicentre prospective study on microwave ablation of liver tumours: preliminary results. HPB (Oxford) 13: 579-585. doi: 10.1111/j.1477-2574.2011.00338.x
[40]	Lee KF, Hui JW, Cheung YS, et al. (2012) Surgical ablation of hepatocellular carcinoma with 2.45-GHz microwave: a critical appraisal of treatment outcomes. Hong Kong Med J 18: 85-91.
[41]	Martin RC, Scoggins CR, McMasters KM (2010) Safety and efficacy of microwave ablation of hepatic tumors: a prospective review of a 5-year experience. Ann Surg Oncol 17: 171-178.
[42]	Lu MD, Xu HX, Xie XY, et al. (2005) Percutaneous microwave and radiofrequency ablation for hepatocellular carcinoma: a retrospective comparative study. J Gastroenterol 40: 1054-1060. doi: 10.1007/s00535-005-1671-3
[43]	Simo KA, Sereika SE, Newton KN, et al. (2011) Laparoscopic-assisted microwave ablation for hepatocellular carcinoma: safety and efficacy in comparison with radiofrequency ablation. J Surg Oncol 104: 822-829.
[44]	Padma S, Martinie JB, Iannitti DA (2009) Liver tumor ablation: percutaneous and open approaches. J Surg Oncol 100: 619-634. doi: 10.1002/jso.21364
[45]	Poon RT, Fan ST, Tsang FH, et al. (2002) Locoregional therapies for hepatocellular carcinoma: a critical review from the surgeon's perspective. Ann Surg 235: 466-486. doi: 10.1097/00000658-200204000-00004
[46]	Ebara M, Ohto M, Sugiura N, et al. (1990) Percutaneous ethanol injection for the treatment of small hepatocellular carcinoma. Study of 95 patients. J Gastroenterol Hepatol 5: 616-626.
[47]	Ng KK, Poon RT, Chan SC, et al. (2011) High-intensity focused ultrasound for hepatocellular carcinoma: a single-center experience. Ann Surg 253: 981-987.
[48]	Cheung TT, Fan ST, Chan SC, et al. (2013) High-intensity focused ultrasound ablation: an effective bridging therapy for hepatocellular carcinoma patients. World J Gastroenterol 19: 3083-3089.
[49]	Zhang T, Zhang J, Cui M, et al. (2013) Hepatitis B virus X protein inhibits tumor suppressor miR-205 through inducing hypermethylation of miR-205 promoter to enhance carcinogenesis. Neoplasia 15: 1282-1291.
[50]	Sabel MS (2009) Cryo-immunology: a review of the literature and proposed mechanisms for stimulatory versus suppressive immune responses. Cryobiology 58: 1-11.
[51]	Schell SR, Wessels FJ, Abouhamze A, et al. (2002) Pro- and antiinflammatory cytokine production after radiofrequency ablation of unresectable hepatic tumors. J Am Coll Surg 195: 774-781.
[52]	Sabel MS, Nehs MA, Su G, et al. (2005) Immunologic response to cryoablation of breast cancer. Breast Cancer Res Treat 90: 97-104. doi: 10.1007/s10549-004-3289-1
[53]	Chen HW, Lai EC, Zhen ZJ, et al. (2011) Ultrasound-guided percutaneous cryotherapy of hepatocellular carcinoma. Int J Surg 9: 188-191. doi: 10.1016/j.ijsu.2010.11.008
[54]	Wang C, Lu Y, Wang H, et al. (2012) Transarterial chemoembolization with/without cryotherapy is associated with improved clinical outcomes of sorafenib for the treatment of advanced hepatocellular carcinoma. Exp Ther Med 4: 188-196.
[55]	Rong G, Bai W, Dong Z, et al. (2015) Cryotherapy for cirrhosis-based hepatocellular carcinoma: a single center experience from 1595 treated cases. Front Med 9: 63-71. doi: 10.1007/s11684-014-0342-2
[56]	Llovet JM, Bruix J (2003) Systematic review of randomized trials for unresectable hepatocellular carcinoma: Chemoembolization improves survival. Hepatology 37: 429-442. doi: 10.1053/jhep.2003.50047
[57]	Llovet JM, Real MI, Montana X, et al. (2002) Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial. Lancet 359: 1734-1739. doi: 10.1016/S0140-6736(02)08649-X
[58]	Lo CM, Ngan H, Tso WK, et al. (2002) Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma. Hepatology 35: 1164-1171. doi: 10.1053/jhep.2002.33156
[59]	Marelli L, Stigliano R, Triantos C, et al. (2007) Transarterial therapy for hepatocellular carcinoma: which technique is more effective? A systematic review of cohort and randomized studies. Cardiovasc Intervent Radiol 30: 6-25.
[60]	Liu Z, Gao F, Yang G, et al. (2014) Combination of radiofrequency ablation with transarterial chemoembolization for hepatocellular carcinoma: an up-to-date meta-analysis. Tumour Biol 35: 7407-7413.
[61]	Ni JY, Liu SS, Xu LF, et al. (2013) Meta-analysis of radiofrequency ablation in combination with transarterial chemoembolization for hepatocellular carcinoma. World J Gastroenterol 19: 3872-3882.
[62]	Lewis AL, Dreher MR (2012) Locoregional drug delivery using image-guided intra-arterial drug eluting bead therapy. J Control Release 161: 338-350. doi: 10.1016/j.jconrel.2012.01.018
[63]	Lammer J, Malagari K, Vogl T, et al. (2010) Prospective randomized study of doxorubicin-eluting-bead embolization in the treatment of hepatocellular carcinoma: results of the PRECISION V study. Cardiovasc Intervent Radiol 33: 41-52.
[64]	Xie ZB, Wang XB, Peng YC, et al. (2015) Systematic review comparing the safety and efficacy of conventional and drug-eluting bead transarterial chemoembolization for inoperable hepatocellular carcinoma. Hepatol Res 45: 190-200. doi: 10.1111/hepr.12450
[65]	Inarrairaegui M, Thurston KG, Bilbao JI, et al. (2010) Radioembolization with use of yttrium-90 resin microspheres in patients with hepatocellular carcinoma and portal vein thrombosis. J Vasc Interv Radiol 21: 1205-1212.
[66]	Salem R, Lewandowski RJ, Mulcahy MF, et al. (2010) Radioembolization for hepatocellular carcinoma using Yttrium-90 microspheres: a comprehensive report of long-term outcomes. Gastroenterology 138: 52-64. doi: 10.1053/j.gastro.2009.09.006
[67]	Meza-Junco J, Montano-Loza AJ, Liu DM, et al. (2012) Locoregional radiological treatment for hepatocellular carcinoma; Which, when and how? Cancer Treat Rev 38: 54-62. doi: 10.1016/j.ctrv.2011.05.002
[68]	Carr BI, Kondragunta V, Buch SC, et al. (2010) Therapeutic equivalence in survival for hepatic arterial chemoembolization and yttrium 90 microsphere treatments in unresectable hepatocellular carcinoma: a two-cohort study. Cancer 116: 1305-1314.
[69]	Bibault JE, Dewas S, Vautravers-Dewas C, et al. (2013) Stereotactic body radiation therapy for hepatocellular carcinoma: prognostic factors of local control, overall survival, and toxicity. PLoS One 8: e77472. doi: 10.1371/journal.pone.0077472
[70]	Goyal K, Einstein D, Yao M, et al. (2010) Cyberknife stereotactic body radiation therapy for nonresectable tumors of the liver: preliminary results. HPB Surg.
[71]	Huang WY, Jen YM, Lee MS, et al. (2012) Stereotactic body radiation therapy in recurrent hepatocellular carcinoma. Int J Radiat Oncol Biol Phys 84: 355-361.
[72]	O'Connor JK, Trotter J, Davis GL, et al. (2012) Long-term outcomes of stereotactic body radiation therapy in the treatment of hepatocellular cancer as a bridge to transplantation. Liver Transpl 18: 949-954. doi: 10.1002/lt.23439
[73]	Tanguturi SK, Wo JY, Zhu AX, et al. (2014) Radiation therapy for liver tumors: ready for inclusion in guidelines? Oncologist 19: 868-879. doi: 10.1634/theoncologist.2014-0097
[74]	Lo CH, Huang WY, Lee MS, et al. (2014) Stereotactic ablative radiotherapy for unresectable hepatocellular carcinoma patients who failed or were unsuitable for transarterial chemoembolization. Eur J Gastroenterol Hepatol 26: 345-352. doi: 10.1097/MEG.0000000000000032
[75]	Que JY, Lin LC, Lin KL, et al. (2014) The efficacy of stereotactic body radiation therapy on huge hepatocellular carcinoma unsuitable for other local modalities. Radiat Oncol 9: 120.
[76]	Feng M, Ben-Josef E (2011) Radiation therapy for hepatocellular carcinoma. Semin Radiat Oncol 21: 271-277.
[77]	Gomaa AI, Waked I (2015) Recent advances in multidisciplinary management of hepatocellular carcinoma. World J Hepatol 7: 673-687. doi: 10.4254/wjh.v7.i4.673
[78]	Cheng AL, Kang YK, Chen Z, et al. (2009) Efficacy and safety of sorafenib in patients in the Asia-Pacific region with advanced hepatocellular carcinoma: a phase III randomised, double-blind, placebo-controlled trial. Lancet Oncol 10: 25-34.
[79]	Llovet JM, Ricci S, Mazzaferro V, et al. (2008) Sorafenib in advanced hepatocellular carcinoma. N Engl J Med 359: 378-390.
[80]	Cainap C, Qin S, Huang WT, et al. (2015) Linifanib versus Sorafenib in patients with advanced hepatocellular carcinoma: results of a randomized phase III trial. J Clin Oncol 33: 172-179.
[81]	Cheng AL, Kang YK, Lin DY, et al. (2013) Sunitinib versus sorafenib in advanced hepatocellular cancer: results of a randomized phase III trial. J Clin Oncol 31: 4067-475. doi: 10.1200/JCO.2012.45.8372
[82]	Johnson PJ, Qin S, Park JW, et al. (2013) Brivanib versus sorafenib as first-line therapy in patients with unresectable, advanced hepatocellular carcinoma: results from the randomized phase III BRISK-FL study. J Clin Oncol 31: 3517-3524.
[83]	Zhu AX, Rosmorduc O, Evans TR, et al. (2015) SEARCH: a phase III, randomized, double-blind, placebo-controlled trial of sorafenib plus erlotinib in patients with advanced hepatocellular carcinoma. J Clin Oncol 33: 559-566. doi: 10.1200/JCO.2013.53.7746
[84]	Llovet JM, Di Bisceglie AM, Bruix J, et al. (2008) Design and endpoints of clinical trials in hepatocellular carcinoma. J Natl Cancer Inst 100: 698-711. doi: 10.1093/jnci/djn134
[85]	Chen MS, Li JQ, Zheng Y, et al. (2006) A prospective randomized trial comparing percutaneous local ablative therapy and partial hepatectomy for small hepatocellular carcinoma. Ann Surg 243: 321-328. doi: 10.1097/01.sla.0000201480.65519.b8
[86]	Huang GT, Lee PH, Tsang YM, et al. (2005) Percutaneous ethanol injection versus surgical resection for the treatment of small hepatocellular carcinoma: a prospective study. Ann Surg 242: 36-42.
[87]	Lu MD, Kuang M, Liang LJ, et al. (2006) Surgical resection versus percutaneous thermal ablation for early-stage hepatocellular carcinoma: a randomized clinical trial. Zhonghua Yi Xue Za Zhi 86: 801-805.
[88]	Lin SM, Lin CJ, Lin CC, et al. (2004) Radiofrequency ablation improves prognosis compared with ethanol injection for hepatocellular carcinoma < or = 4 cm. Gastroenterology 127: 1714-1723.
[89]	Lin SM, Lin CJ, Lin CC, et al. (2005) Randomised controlled trial comparing percutaneous radiofrequency thermal ablation, percutaneous ethanol injection, and percutaneous acetic acid injection to treat hepatocellular carcinoma of 3 cm or less. Gut 54: 1151-1156. doi: 10.1136/gut.2004.045203
[90]	Shiina S, Teratani T, Obi S, et al. (2005) A randomized controlled trial of radiofrequency ablation with ethanol injection for small hepatocellular carcinoma. Gastroenterology 129: 122-130. doi: 10.1053/j.gastro.2005.04.009
[91]	European Association For The Study Of The L, European Organisation For R, Treatment Of C. (2012) EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol 56: 908-943.
[92]	Chong CC, Wong GL, Wong VW, et al. (2015) Antiviral therapy improves post-hepatectomy survival in patients with hepatitis B virus-related hepatocellular carcinoma: a prospective-retrospective study. Aliment Pharmacol Ther 41: 199-208.
[93]	Wong JS, Wong GL, Tsoi KK, et al. (2011) Meta-analysis: the efficacy of anti-viral therapy in prevention of recurrence after curative treatment of chronic hepatitis B-related hepatocellular carcinoma. Aliment Pharmacol Ther 33: 1104-1112. doi: 10.1111/j.1365-2036.2011.04634.x
[94]	Miao RY, Zhao HT, Yang HY, et al. (2010) Postoperative adjuvant antiviral therapy for hepatitis B/C virus-related hepatocellular carcinoma: a meta-analysis. World J Gastroenterol 16: 2931-2342.
[95]	Zhou Y, Zhang Z, Zhao Y, et al. (2014) Antiviral therapy decreases recurrence of hepatitis B virus-related hepatocellular carcinoma after curative resection: a meta-analysis. World J Surg 38: 2395-2402.
[96]	Li N, Lai EC, Shi J, et al. (2010) A comparative study of antiviral therapy after resection of hepatocellular carcinoma in the immune-active phase of hepatitis B virus infection. Ann Surg Oncol 17: 179-185. doi: 10.1245/s10434-009-0694-z
[97]	Wong GL, Tse YK, Chan HL, et al. (2016) Oral nucleos(t)ide analogues reduce recurrence and death in chronic hepatitis B-related hepatocellular carcinoma. Aliment Pharmacol Ther.
[98]	Lo AO, Wong GL (2014) Current developments in nucleoside/nucleotide analogues for hepatitis B. Expert Rev Gastroenterol Hepatol 8: 607-622. doi: 10.1586/17474124.2014.909724

Reader Comments

Your name:*

Email:*
© 2016 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)