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Kim A, Park S, Lee H, Cho H, Kang H. PCN90 Development of Time-Dependent Markov MODEL to Evaluate the Cost-Effectiveness of Treatment Options for Relapsed or Refractory Peripheral T-CELL Lymphoma in South Korea. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Lee DK, Kang MS, Cho H. MRI size assessment of cerebral microvasculature using diffusion-time-dependent stimulated-echo acquisition: A feasibility study in rodent. Neuroimage 2020; 215:116784. [PMID: 32276059 DOI: 10.1016/j.neuroimage.2020.116784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 03/18/2020] [Accepted: 03/21/2020] [Indexed: 11/19/2022] Open
Abstract
In this study, a stimulated-echo (STE) method was employed to robustify the cerebral vessel size estimation near air-tissue, bone-tissue interfaces, and large vessels. The proposed solution is to replace the relaxation rate change from gradient-echo (GRE) with that from STE with long diffusion time after the injection of an intravascular contrast agent, superparamagnetic iron oxide nanoparticles. The corresponding diffusion length of STE is shorter than the length over which the unwanted macroscopic field inhomogeneities but is still longer than the correlation length of the fields induced by small vessels. Therefore, the unwanted field inhomogeneities are refocused, while preserving microscopic susceptibility contrast from cerebral vessels. The mean vessel diameter (dimensionless) derived from the diffusion-time-varying STE method was compared to the mean vessel diameter obtained by a conventional spin-echo (SE) and GRE combination based on Monte-Carlo proton diffusion simulations and in vivo rat experiments at 7 T. The in vivo mean vessel diameter from the MRI experiments was directly compared to available reference mouse brain vasculature obtained by a knife-edge scanning microscope (KESM), which is considered to be the gold standard. Monte-Carlo simulation revealed that SE and GRE-based MR relaxation rate changes (ΔR2 and ΔR2∗, respectively) can be enhanced using single STE-based MR relaxation rate change (ΔRSTE) by regulating diffusion time, especially for small vessels. The in vivo mean vessel diameter from the STE method demonstrated a closer agreement with that from the KESM compared to the combined SE and GRE method, especially in the olfactory bulb and cortex. This study demonstrates that STE relaxation rate changes can be used as consistent measures for assessing small cerebral microvasculature, where macroscopic field inhomogeneity is severe and signal contamination from adjacent large vessels is significant.
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Kwon MR, Shin JH, Park H, Cho H, Kim E, Hahn SY. Radiomics Based on Thyroid Ultrasound Can Predict Distant Metastasis of Follicular Thyroid Carcinoma. J Clin Med 2020; 9:E2156. [PMID: 32650493 PMCID: PMC7408789 DOI: 10.3390/jcm9072156] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 06/30/2020] [Accepted: 07/06/2020] [Indexed: 12/22/2022] Open
Abstract
We aimed to evaluate whether radiomics analysis based on gray-scale ultrasound (US) can predict distant metastasis of follicular thyroid cancer (FTC). We retrospectively included 35 consecutive FTCs with distant metastases and 134 FTCs without distant metastasis. We extracted a total of 60 radiomics features derived from the first order, shape, gray-level cooccurrence matrix, and gray-level size zone matrix features using US imaging. A radiomics signature was generated using the least absolute shrinkage and selection operator and was used to train a support vector machine (SVM) classifier in five-fold cross-validation. The SVM classifier showed an area under the curve (AUC) of 0.90 on average on the test folds. Age, size, widely invasive histology, extrathyroidal extension, lymph node metastases on pathology, nodule-in-nodule appearance, marked hypoechogenicity, and rim calcification on the US were significantly more frequent among FTCs with distant metastasis compared to those without metastasis (p < 0.05). Radiomics signature and widely invasive histology were significantly associated with distant metastasis on multivariate analysis (p < 0.01 and p = 0.003). The classifier using the results of the multivariate analysis showed an AUC of 0.93. The radiomics signature from thyroid ultrasound is an independent biomarker for noninvasively predicting distant metastasis of FTC.
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Cho H, Kishikawa T, Tokita Y, Suzuki M, Takemoto N, Hanamoto A, Fukusumi T, Yamamoto M, Fujii M, Ohno Y, Inohara H. Prevalence of human papillomavirus in oral gargles and tonsillar washings. Oral Oncol 2020; 105:104669. [PMID: 32259682 DOI: 10.1016/j.oraloncology.2020.104669] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 03/02/2020] [Accepted: 03/26/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Human papillomavirus (HPV) infection drives carcinogenesis in the oropharynx. No standard sampling or HPV detection methods for evaluating oropharyngeal HPV infection exist. The prevalence of oral HPV infection in Japan is unknown. MATERIALS AND METHODS We examined 435 healthy Japanese individuals to address whether adding tonsillar washing to oral gargling would improve HPV detection. We compared HPV assessment using GENOSEARCH HPV31 versus nested PCR and direct sequencing. Associations between HPV infection and demographic and behavioral characteristics were examined. RESULTS Most participants who were HPV-positive based on oral gargles were also HPV-positive based on tonsillar washings: 11 (64.7%) of 17 on nested PCR and 12 (70.6%) of 17 on GENOSEARCH HPV31. Although HPV infection was more prevalent in oral gargles followed by tonsillar washings than in oral gargles alone, the difference was not statistically significant (nested PCR, 4.8% vs. 3.9%, P = 0.46; GENOSEARCH HPV31, 5.3% vs. 3.9%, P = 0.33). The overall agreement between nested PCR and GENOSEARCH HPV31 was 98.6%, with 76.0% positive agreement. The overall prevalence of oral HPV infection in Japan was 5.7% (95% confidence interval, 3.9-8.3%). Men had a significantly higher prevalence of oral HPV infection than women (8.3% vs. 2.6%, P = 0.02). Infection increased with number of lifetime sexual partners (P < 0.001 for trend). CONCLUSION The oropharynx is probably the major source of HPV-infected cells in oral gargles. Oral gargling could be a standard sampling method for evaluating oropharyngeal HPV infection. GENOSEARCH HPV31 could be an option for oral HPV detection.
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Oh G, Lee H, Oh J, Cho H, Choi J, Jung S, Kim J, Jeon E, Kang S. Role of Anti-Vimentin Antibodies in Pre-Sensitized Korean Heart Transplant Patients. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Kwon MR, Shin JH, Park H, Cho H, Hahn SY, Park KW. Radiomics Study of Thyroid Ultrasound for Predicting BRAF Mutation in Papillary Thyroid Carcinoma: Preliminary Results. AJNR Am J Neuroradiol 2020; 41:700-705. [PMID: 32273326 DOI: 10.3174/ajnr.a6505] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 12/17/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND PURPOSE It is not known how radiomics using ultrasound images contribute to the detection of BRAF mutation. This study aimed to evaluate whether a radiomics study of gray-scale ultrasound can predict the presence or absence of B-Raf proto-oncogene, serine/threonine kinase (BRAF) mutation in papillary thyroid cancer. MATERIALS AND METHODS The study retrospectively included 96 thyroid nodules that were surgically confirmed papillary thyroid cancers between January 2012 and June 2013. BRAF mutation was positive in 48 nodules and negative in 48 nodules. For analysis, ROIs from the nodules were demarcated manually on both longitudinal and transverse sonographic images. We extracted a total of 86 radiomics features derived from histogram parameters, gray-level co-occurrence matrix, intensity size zone matrix, and shape features. These features were used to build 3 different classifier models, including logistic regression, support vector machine, and random forest using 5-fold cross-validation. The performance including accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve, of the different models was evaluated. RESULTS The incidence of high-suspicion nodules diagnosed on ultrasound was higher in the BRAF mutation-positive group than in the mutation-negative group (P = .004). The radiomics approach demonstrated that all classification models showed moderate performance for predicting the presence of BRAF mutation in papillary thyroid cancers with an area under the curve value of 0.651, accuracy of 64.3%, sensitivity of 66.8%, and specificity of 61.8%, on average, for the 3 models. CONCLUSIONS Radiomics study using thyroid sonography is limited in predicting the BRAF mutation status of papillary thyroid carcinoma. Further studies will be needed to validate our results using various diagnostic methods.
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Kim D, Choi J, Cho H, Jung S, Lee J, Lee H, Kang S, Kim J, Jeon E. The Prognostic Importance of Perioperative Renal Function and Outcome of Patients Undergoing Heart Transplantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Asasira J, Mai T, Lee S, Wabinga H, Chang Y, Jung SY, Cho H. Planning for future cancer control programs in Uganda: Projections of top five cancers’ incidence in the next decade. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz432.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Choi J, Cho H, Chay D, Kwon H, Han G, Kim J. Autotaxin in malignant ascites promotes invadopodia formation via reactive oxygen species in ovarian cancer. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Chay D, Han G, Cho H, Kim S, Kim J. High expression of TRPV-1 is associated with poor prognosis in cervical cancer. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Hua V, Cho H, Li S, Sarin K. 269 Comorbidity clusters in hidradenitis suppurativa in a large commercially insured population in the US. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lee JY, Cho H, Hwang E, Kim SY, Kim S. Structural and molecular modelling studies of antimelanogenic piper-amide TRPM1 antagonists. SAR AND QSAR IN ENVIRONMENTAL RESEARCH 2019; 30:195-207. [PMID: 30773912 DOI: 10.1080/1062936x.2019.1574894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Indexed: 06/09/2023]
Abstract
Piper-amides exhibit diverse biological activities, including antimelanogenic effects. In our previous studies, we identified a potent piper-amide derivative that inhibited melanogenesis via the TRPM1 calcium channel. Despite its potential as a therapeutic target, the three-dimensional structure of TRPM1 is still not available. Thus, structure-guided compound design and the discovery of novel inhibitors of melanogenesis have been limited. In the present study, a series of computational methods, including homology modelling, docking, molecular dynamics simulation and field-based pharmacophore modelling, were integrated to explore the structural features of natural piper-amide-like compounds related to the TRPM1 target. These studies suggested the binding mode and provided a 3D pharmacophore model of the ligands, which can be helpful in understanding the TRPM1-ligand interactions at the molecular level and in designing potent antagonists of TRPM1.
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Boku N, Ryu MH, Kato K, Chung HC, Minashi K, Lee KW, Cho H, Kang WK, Komatsu Y, Tsuda M, Yamaguchi K, Hara H, Fumita S, Azuma M, Chen LT, Kang YK. Safety and efficacy of nivolumab in combination with S-1/capecitabine plus oxaliplatin in patients with previously untreated, unresectable, advanced, or recurrent gastric/gastroesophageal junction cancer: interim results of a randomized, phase II trial (ATTRACTION-4). Ann Oncol 2019; 30:250-258. [PMID: 30566590 PMCID: PMC6386029 DOI: 10.1093/annonc/mdy540] [Citation(s) in RCA: 268] [Impact Index Per Article: 53.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Nivolumab is approved as an option for third- or later-line treatment of advanced gastric/gastroesophageal junction (G/GEJ) cancer in several countries after ATTRACTION-2. To further improve the therapeutic efficacy of first-line therapy, exploration of a nivolumab-chemotherapy combination is warranted. In part 1 (phase II) of ATTRACTION-4, the safety and efficacy of nivolumab combined with S-1 plus oxaliplatin (SOX) or capecitabine plus oxaliplatin (CapeOX) as first-line therapy for unresectable advanced or recurrent human epidermal growth factor receptor 2 (HER2)-negative G/GEJ cancer were evaluated. PATIENTS AND METHODS Patients were randomized (1 : 1) to receive nivolumab (360 mg intravenously every 3 weeks) plus SOX (S-1, 40 mg/m2 orally twice daily for 14 days followed by 7 days off; oxaliplatin, 130 mg/m2 intravenously on day 1 every 3 weeks) or CapeOX (capecitabine, 1000 mg/m2 orally twice daily for 14 days followed by 7 days off; oxaliplatin, 130 mg/m2 intravenously on day 1 every 3 weeks) until disease progression, unacceptable toxicity, or consent withdrawal. RESULTS Of 40 randomized patients, 39 (nivolumab plus SOX, 21; nivolumab plus CapeOX, 18) and 38 (21 and 17, respectively) comprised the safety and efficacy populations, respectively. Most frequent (>10%) grade 3/4 treatment-related adverse events were neutropenia (14.3%) in the nivolumab plus SOX group, and neutropenia (16.7%), anemia, peripheral sensory neuropathy, decreased appetite, type 1 diabetes mellitus, and nausea (11.1% each) in the nivolumab plus CapeOX group. No treatment-related death occurred. Objective response rate was 57.1% (95% confidence interval 34.0-78.2) with nivolumab plus SOX and 76.5% (50.1-93.2) with nivolumab plus CapeOX. Median overall survival was not reached (NR) in both groups. Median progression-free survival was 9.7 months (5.8-NR) and 10.6 months (5.6-12.5), respectively. CONCLUSION Nivolumab combined with SOX/CapeOX was well tolerated and demonstrated encouraging efficacy for unresectable advanced or recurrent HER2-negative G/GEJ cancer. ATTRACTION-4 has proceeded to part 2 (phase III) to compare nivolumab plus SOX/CapeOX versus placebo plus SOX/CapeOX. CLINICALTRIALS.GOV ID NCT02746796.
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Choi J, Jeon C, Cho H, Kim J, Han K, Kim A, Jung S. Detection of heterozygous mutations in circulating tumor cells separated by lateral magnetophoretic microseparator. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Wickramasuriya S, Kim E, Macelline S, Shin T, Cho H, Heo J. PSXVI-35 Egg production performance and egg quality of laying hens fed a diet supplemented with deoxynivalenol mycotoxins contaminated corn distillers dried grains with soluble. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Otsuka T, Fujiishi K, Matsumoto K, Kimura T, Koike R, Cho H, Hasegawa A, Nishio M, Otozai S, Yoshii T, Kudo T, Fujisawa F, Sugimoto N, Yagi T, Imamura F, Fujii T. Association of immune-related adverse events and efficacy in Japanese patients with squamous cell carcinoma of the head and neck treated with nivolumab. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy438.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kim J, Lee H, Lee G, Cho H, Lee J, Kang M. Addressing the gap between ANC service’s intention and behavior with a focus on self-efficacy. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky218.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kim N, Cho H, Yun M, Park K, Lee C. Early Prediction of Response to Radiation Therapy Using Inter-Fractional 18F-FDG PET/CT in Esophageal Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Cho H, Ryu MH, Kim B, Park Y, Na YS, Ma J, Beck M, Kang YK. Phase II study of paclitaxel in patients with advanced gastrointestinal stromal tumor (GIST) after failure of at least both imatinib and sunitinib. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy299.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Cho H, Ryu MH, Chae H, Lee S, Park Y, Kim KH, Kim C, Kim B, Yoo MW, Ma J, Beck M, Kim M, Kang YK. Prognostic factors for residual lesion surgery following disease control with standard dose imatinib (IM) treatment in patients (pts) with advanced gastrointestinal stromal tumor (GIST). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy299.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Park J, Moon S, Cho H, Kim D, Yoon Y, Cho Y. 350 Effect of Team-Based CPR Training for Emergency Medical Services Providers on Out-of-Hospital Return of Spontaneous Circulation in Cardiac Arrest Patients. Ann Emerg Med 2018. [DOI: 10.1016/j.annemergmed.2018.08.355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Shin M, Xuan MTT, Lee S, Chang Y, Cho H. How Cancer Patients Reported Their Quality of Life? Findings From a Nationwide Cross-Sectional Survey in Korea. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.52200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Cancer treatments have negative physical and socio-emotional consequences. Understanding which problems cancer patients are suffering and their quality of life (QOL) status is therefore important. Aim: This study aimed to describe how cancer patients reported their QOL and factors associated therewith. Methods: A total of 689 cancer patients aged ≥ 19 were selected from the Korea National and Nutrition Examination Survey (KNHANES), 2007-2015. HRQOL was measured using the five dimensions and summary index (ranges from 0 to 1) of the EuroQOL-5 (EQ-5D). Higher index score and less problems reported in dimensions indicates better QOL status. Logistic regression was performed to analyze the probability of cancer patient reporting problem in QOL dimensions. Statistical analyses were adjusted for sample weights. Result: Of 689 participants, mean age was 57.7 ± 0.67, 47.9% were male, 80.4% lived in urban area. 29.3% had hypertension and 15.3% had arthritis as comorbidity. Mean EQ-5D index score was 0.898 ± 0.007; higher score was noted in 19-65 age group (0.932 ± 0.007), living in urban area (0.906 ± 0.008), living in apartment (0.926 ± 0.008), male gender (0.912 ± 0.011), higher income, higher education level and more comorbidities ( P < 0.05). Participants reported more problems in pain or discomfort (34.09%), followed by mobility (24.91%) and usual activities (19.72%). Less problems were recorded in depression (17.37%) and self-care (8.04%). Patients with two or more comorbidities experienced higher chance of reporting problems in mobility, usual activity and self-care (aOR 4.01, 3.11 and 2.82 respectively, P < 0.05). Older age group was associated with higher chance of reporting problems in all QOL dimensions. Female cancer patients experienced higher chance of reporting problems in pain/discomfort and depression/anxiety (aOR 2.11 and 2.18 respectively, P < 0.05). Conclusion: More than one third of Korean adult cancer patients reported moderate or severe level of pain and discomfort. Older age, female gender and having two or more comorbidities were factors associated with lower QOL.
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Lee KW, Kim J, Kim J, Kang B, Chung I, Hong Y, Kim TY, Lee K, Zang D, Ko Y, Song EK, Baek J, Koo D, Oh S, Cho H. Treatment patterns and changes in quality of life during first-line palliative chemotherapy in Korean patients with advanced gastric cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Park C, Cho H, Choi Y, Oh I, Kim Y. P1.01-77 Osimertinib in the First-Line Treatment of Non-Small Cell Lung Cancer Harboring Activating EGFR Mutation from Circulating Tumor DNA. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cho YY, Lee JH, Chang Y, Nam JY, Cho H, Lee DH, Cho EJ, Lee DH, Yu SJ, Lee JM, Kim YJ, Yoon JH. Comparison of overall survival between antiviral-induced viral suppression and inactive phase chronic hepatitis B patients. J Viral Hepat 2018; 25:1161-1171. [PMID: 29741286 DOI: 10.1111/jvh.12927] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 04/09/2018] [Indexed: 12/16/2022]
Abstract
Nucleot(s)ide analogues (NAs) reduce the risk of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients. However, the risk of HCC is reportedly higher for NA-treated patients than for patients in the inactive CHB phase. This study aimed to compare the long-term outcomes of CHB patients with NA-induced viral suppression and those of patients with inactive CHB. This retrospective study involved 1118 consecutive CHB patients whose HBV DNA level was continuously <2000 IU/mL during follow-up with/without antiviral agents. The patients were classified into inactive CHB (n = 373) or NA groups (n = 745). The primary endpoint was overall survival. Secondary endpoints included development of HCC and other liver-related events. The median duration of follow-up was 41.0 (interquartile range = 26.5-55.0) months. The difference in overall survival between the NA group vs. the inactive CHB group was not significant (hazard ratio [HR] = 0.78; 95% confidence interval [CI] = 0.33-1.85; P = .57). The NA group showed a significantly higher risk of HCC (HR = 3.44; 95% CI = 1.82-6.52; P < .01), but comparable risk for non-HCC liver-related events (HR = 1.02; 95% CI = 0.66-1.59; P = .93), compared with the inactive CHB group. Among patients with cirrhosis, the NA group showed a significantly lower risk of death (HR = 0.31; 95% CI = 0.097-0.998; P = .05) and non-HCC liver-related events (HR = 0.51; 95% CI = 0.31-0.83; P < .01), but a slightly higher risk of HCC (HR = 2.39; 95% CI = 0.85-6.75; P = .09), compared to the inactive CHB group. The overall survival of untreated patients with inactive CHB and of CHB patients achieving viral suppression with NA was comparable. However, NA treatment of cirrhotic patients was significantly associated with longer overall survival and lower risk of liver-related events.
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