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Clues to Preventing Return of Liver Cancer
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Previous research has shown that antiviral therapy reduces the incidence of liver cancer in such patients.
This study looked at 15 patients with chronic hepatitis B (CHB) who underwent the local removal of a liver tumor known as a "single hepatocellular carcinoma" (HCC) that was less than four centimeters. HCC is the most common primary malignant tumor of the liver.
Six of the patients were diagnosed between 1991 and 1997, prior to the development of antiviral therapy. They were classified as historical controls.
The other nine were diagnosed between 2000 and 2004 and began ongoing antiviral therapy with lamivudine immediately after HCC diagnosis. In some cases, patients were also prescribed other antiviral medications, such as tenofovir and adefovir.
Median survival among patients who received antiviral therapy immediately after HCC diagnosis was 60 months, compared with 12.5 months for the historical control patients. Seven of the nine patients who began immediate antiviral therapy have not developed a new HCC or recurrence. The longest survivors have been cancer-free for more than 10 years.
"Before the antiviral drugs were developed, patients would often develop new lesions within a few months of tumor [removal] because we were not treating the underlying virus that is causing the cancer. The virus drives the cancer, and by suppressing the virus ... we can extend the survival of these patients," study author Dr. Hie-Won Hann, a professor of medicine at Jefferson Medical College of Thomas Jefferson University, said in a university news release.
Another option for patients with recurrent liver cancer is a liver transplant, which carries its own risk and is not always available.
Antiviral therapy, like virtually all therapies, is not risk-free. Common side effects of lamivudine, for example, include appetite loss, diarrhea, indigestion, and fatigue; more rare severe side effects that require immediate medical attention include a severe allergic reaction (rash, itching, chest tightness and swelling of the mouth, lips, face or tongue; dark urine; fast or irregular heartbeat; and yellowing of the eyes or skin.
The study was recently published in the International Journal of Cancer.
-- Robert Preidt
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SOURCE: Thomas Jefferson University, June 24, 2010, news release