Role of lamivudine with transarterial chemoembolization in the survival of patients with hepatocellular carcinoma.

Background and Aim The purpose of the present study was to determine whether lamivudine in combination with transarterial chemoembolization ( TACE) could reduce hepatitis B virus ( HBV) activation and improve the survival of patients with hepatocellular carcinoma ( HCC). Methods From July 2008 to October 2011, a total of 181 consecutive HBV-related HCC patients undergoing TACE were randomized to two groups (92: lamivudine, 89: control). Follow up was every 3 months. Primary and secondary end-points were time to progression ( TTP) and overall survival ( OS), respectively, both of which were evaluated by the Kaplan-Meier technique and summarized by the hazard ratio. Results The level of HBV-DNA became undetectable in 42 (45.6%) patients in the lamivudine group, compared with 10 (11.2%) in the control group ( P < 0.001). The median TTP was 8.2 months in lamivudine group and 4.3 months in control group ( P = 0.005), and lamivudine therapy was an independent protective factor related to TTP ( P = 0.006). Moreover, 1-, 2-, and 3-year survival rates were 83%, 69%, and 58% in lamivudine group and 60%, 48%, and 48% in control group, respectively ( P = 0.002). With multivariate Cox regression model, lamivudine therapy ( P = 0.002) and α-fetoprotein ( AFP) level ( P = 0.003) were two independent predictors for OS. Conclusion Lamivudine therapy could reduce HBV activation and improve survival of HCC patients treated with TACE. Lamivudine therapy and AFP level are two independent factors affecting OS. [ABSTRACT FROM AUTHOR]