Hepatitis B virus mutation may play a role in hepatocellular carcinoma recurrence: A systematic review and meta-regression analysis

Background and Aims A number of studies have confirmed that antiviral therapy with nucleotide analogs (NAs) can improve the prognosis of hepatitis B virus (HBV)‐related hepatocellular carcinoma (HCC) after curative therapy. However, what factors affected the prognosis of HBV‐HCC after removal of the primary tumor and inhibition of HBV replication? A meta‐regression analysis was conducted to explore the prognostic factor for this subgroup of patients. Methods MEDLINE, EMBASE, Web of Science, and Cochrane library were searched from January 1995 to February 2014 for clinical trials evaluating the effect of NAs on the prognosis of HBV‐HCC after curative therapy. Data were extracted for host, viral, and intervention information. Single‐arm meta‐analysis was performed to assess overall survival (OS) rates and HCC recurrence. Meta‐regression analysis was carried out to explore risk factors for 1‐year OS rate and HCC recurrence for HBV‐HCC patients after curative therapy and antiviral therapy. Results Fourteen observational studies with 1284 patients met the inclusion criteria. Influential factors for prognosis of HCC were mainly baseline HBeAg positivity, cirrhotic stage, advanced Tumor‐Node‐Metastasis (TNM) stage, macrovascular invasion, and antiviral agent type. The 1‐year OS rate decreased by more than four times (coefficient −4.45, P