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Oral Medications Enhance Adherence to Surveillance for Hepatocellular Carcinoma and Survival in Chronic Hepatitis B Patients
- Title
- Oral Medications Enhance Adherence to Surveillance for Hepatocellular Carcinoma and Survival in Chronic Hepatitis B Patients
- Authors
- Nam, Joon Yeul; Lee, Jeong-Hoon; Kim, Hwi Young; Kim, Jieun E.; Lee, Dong Hyeon; Chang, Young; Cho, Hyeki; Yoo, Jeong-Ju; Lee, Minjong; Cho, Young Youn; Cho, Yuri; Cho, Eunju; Yu, Su Jong; Kim, Yoon Jun; Yoon, Jung-Hwan
- Ewha Authors
- 김지은; 김휘영
- SCOPUS Author ID
- 김지은; 김휘영
- Issue Date
- 2017
- Journal Title
- PLOS ONE
- ISSN
- 1932-6203
- Citation
- PLOS ONE vol. 12, no. 1
- Publisher
- PUBLIC LIBRARY SCIENCE
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Background/Aims Regular surveillance for hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients is essential to detect HCC earlier and to improve prognosis. This study investigated whether prescription of oral medication contributes to adherence to surveillance, early tumor detection, and overall survival (OS). Methods A total of 401 CHB patients who were newly diagnosed with HCC were included: 134 patients received no medication (group 1), 151 received hepatoprotective agents such as ursodeoxycholic acid and silymarin (group 2), and 116 received antiviral agents (group 3) at two years before HCC diagnosis. The primary endpoint was OS, and secondary endpoints were compliance to regular surveillance and HCC status at diagnosis. Results Compared to group 1, both group 2 and 3 had higher rates of good compliance to regular surveillance (defined as participation in >80% of imaging intervals being <= 6 months) (58.2%, 90.1%, and 97.4%, respectively; P<0.001), more HCC diagnosed at a very early stage (20.9%, 32.5%, and 36.2%; P = 0.019) and smaller tumor size (2.8+/-2.4cm, 1.9+/-1.1cm, and 1.8+/-0.9cm; P<0.001). Finally, compared to group 1, both group 2 (hazard ratio, 0.63; 95% confidence interval, 0.41 - 0.97; P = 0.035) and group 3 (hazard ratio, 0.40; 95% confidence interval, 0.22-0.71; P = 0.002) had significantly longer OS. In mediation analysis, prolonged OS is resulted considerably from indirect effect mediated by shorter imaging interval (>100% in group 2 and 14.5% in group 3) rather than direct effect of medication itself. Conclusions Prescription of oral medication improves compliance to surveillance and enables early detection of HCC, which is associated with enhanced survival.
- DOI
- 10.1371/journal.pone.0166188
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
- Files in This Item:
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