Tenofovir disoproxil fumarate versus entecavir on the prognosis of hepatitis B virus-related hepatocellular carcinoma after surgical resection: a systematic review and meta-analysis

TL;DR

This study compares two antiviral drugs, TDF and ETV, in treating hepatitis B-related liver cancer after surgery, finding that TDF improves survival and reduces late recurrence.

Contribution

This is the first meta-analysis comparing TDF and ETV effects on HBV-related HCC prognosis after surgery.

Findings

TDF improves recurrence-free survival and reduces late recurrence risk compared to ETV.

TDF is associated with better overall survival and lower mortality risk than ETV.

TDF does not significantly affect early recurrence rates compared to ETV.

Abstract

Entecavir (ETV) and tenofovir disoproxil fumarate (TDF) are first-line antiviral treatment methods for chronic hepatitis B virus (HBV) infection. However, the different effects of TDF versus ETV on the prognosis of HBV-related hepatocellular carcinoma (HCC) after surgical resection remain controversial. We conducted this meta-analysis to assess the differences of TDF versus ETV in recurrence and survival for HBV-related HCC after liver resection.

We searched MEDLINE, EMBASE, PubMed and Web of Science for the related studies published before January 2025. Meta-analysis was performed by use of a random-effects model.

A total of 15 studies were included in this meta-analysis. The pooled results showed that TDF was associated with better recurrence-free survival (RFS) (HR= 0.79, 95% CI 0.70-0.88) and lower risk of recurrence (HR=0.73, 95% CI 0.62-0.86) than ETV in HBV-related HCC patients after surgical resection. Further analysis indicated that TDF reduced the risk of late recurrence (HR= 0.70, 95% CI 0.55-0.88) rather than early recurrence (HR= 1.00, 95% CI 0.85-1.17) compared with ETV. Also, the pooled results revealed that TDF was associated with better overall survival (OS) (HR= 0.55, 95% CI 0.41-0.74) and lower risk of overall mortality (HR= 0.55, 95% CI 0.41-0.74) than ETV.

This meta-analysis provided evidence that TDF has better benefits in improving survival and reducing late recurrence than ETV in HBV-related HCC patients after surgical resection.

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