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. 2025 May 27:15:1462794.
doi: 10.3389/fonc.2025.1462794. eCollection 2025.

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

Yong Wang  1 , Jia-Yu Wu  2 , Qian Xiang  2 , Tian-Fen Liao  2 , Xiao-Yan Jiang  2 , Jing Chen  2
Affiliations

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

Yong Wang et al. Front Oncol. .

Abstract

Background and aim: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: entecavir; hepatitis B; hepatocellular carcinoma; resection; tenofovir.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Screening and selection process of studies.
Figure 2
Figure 2
Forest plot for comparison of TDF and ETV on RFS/DFS (A), risk of recurrence (B) and risk of early and late recurrence (C) in HBV-related HCC patients after surgical resection. TDF, tenofovir; ETV, entecavir; RFS, recurrence-free survival; DFS, disease-free survival; HBV, hepatitis B virus; HCC, hepatocellular carcinoma; HR, hazard ratio.
Figure 3
Figure 3
Forest plot for comparison of TDF and ETV on OS (A) and risk of mortality (B) in HBV-related HCC patients after surgical resection. TDF, tenofovir; ETV, entecavir; OS, overall survival; HBV, hepatitis B virus; HCC, hepatocellular carcinoma; HR, hazard ratio.
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