POSTOPERATIVE ADJUVANT ASPIRIN FOR PATIENTS WITH HEPATITIS B VIRUS-RELATED HEPATOCELLULAR CARCINOMA AND PORTAL VEIN TUMOR THROMBUS: AN OPEN-LABEL, RANDOMIZED CONTROLLED TRIAL

Main Article Content

Wajiha Imam
Hafiza Qurat Ul Ain
Yusra Aimen
Umer Javed

Keywords

Adjuvant aspirin, Hepatitis B, Hepatocellular carcinoma, Portal vein tumor thrombus

Abstract

Objectives: To compare the recurrence free and overall survival with either post-operative adjuvant use of aspirin or surgery alone in patients having hepatitis B related hepatocellular carcinoma and portal vein tumor thrombus.  


Study Design: Randomized controlled trial.


Place and duration of study: This study was conducted at CMH Hospital, Multan from the 1st of July 2022 to the 31st of December 2023.


Methods: A total of 120 patients above the age of 20 years diagnosed with hepatitis B related resectable HCC and associated PVTT, fulfilling the criteria for surgical procedure and planned for surgical resection were included and randomized into 2 equal groups of 60 patients each.


In Group A patients were recommended adjuvant aspirin at a dose of 75 mg daily while in Group B patients were not given this adjuvant therapy.  Primary outcomes of the study were set as recurrence free survival and overall survival at the end of 1 year study period while the secondary outcomes were time duration until any recurrence of the primary tumor was reported and time duration until the recurrence of the tumor in the portal vein was reported. 


 


Results: The Mean±SD of age in this study was 55±6.76 years. The results of the primary outcomes of the study show significantly better recurrence free survival (70% Vs 50%, p=0.025) and overall survival (83.33% Vs66.66%, p=0.035) in Group A compared to Group B. Similarly, the results of secondary outcomes of the study show significantly longer duration for diagnosis of primary tumor (10.33±2.6 Vs 8.33±3.55 months, p=0.015) and diagnosis of portal vein tumor (10.9±2.02 Vs9.6±2.27 months, p=0.022) in Group-A compared to Group-B.


Conclusion:   


Postoperative adjuvant aspirin significantly increases the recurrence free and overall survival of patients having hepatitis B related hepatocellular carcinoma and portal vein tumor thrombus. 

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