The Achievement of a Sustained Virological Response Either Before or After Hepatectomy Improves the Prognosis of Patients with Primary Hepatitis C Virus-Related Hepatocellular Carcinoma
Hepatitis C virus (HCV) infection is a major cause of hepatocellular carcinoma (HCC). Achieving a sustained virological response (SVR) is associated with a reduced risk of recurrence. The recent introduction of direct acting antivirals (DAAs) has resulted in SVR rates of nearly 100% in treated patients. The purpose of the present study was to clarify the outcomes in patients who underwent antiviral therapy and patients without antiviral therapy.
This retrospective study included 220 patients with primary HCV-related HCC who underwent hepatectomy. An SVR was defined as a serum HCV-RNA titer below the detection sensitivity limit at 6 months after the termination of antiviral therapy. Postoperative antiviral therapy was introduced after confirming that there was no early recurrence.
Eighty-eight patients received antiviral therapy. Among these, 58 patients (66%) obtained an SVR. With the exception of one patient, all patients who received DAAs obtained an SVR. The overall survival rate of the pre-operative SVR group was significantly better than that of the preoperative untreated group (P = 0.045). Moreover, there was no recurrence at 3 years after surgery in the pre-operative SVR group. The achievement of an SVR was an independent predictor of overall survival [hazard ratio (HR) 0.75, 95% confidence interval (CI) 0.59–0.94, P = 0.011] and recurrence (HR 0.61, 95% CI 0.40–0.94, P = 0.024).
Obtaining an SVR either before or after surgery was associated with the suppression of HCC recurrence after hepatectomy in patients with primary HCV-related HCC.
There are no grants or other financial support for this study.
The authors declare that there have no conflicts of interest.
- 1.Vital statistics, Ministry of Health, Labour and Welfare. http://www.mhlw.go.jp/english/database/db-hw/vs01.html. Accessed 25 Sep 2017.
- 2.Kudo M, Izumi N, Sakamoto M, et al. Liver Cancer Study Group of Japan. Survival analysis over 28 years of 173,378 patients with hepatocellular carcinoma in Japan. Liver Cancer. 2016;5:190–7.Google Scholar
- 7.Matsuda M, Fujii H, Kono H, Matsumoto Y. Surgical treatment of recurrent hepatocellular carcinoma based on the mode of recurrence: repeat hepatic resection or ablation are good choices for patients with recurrent multicentric cancer. J Hepatobiliary Pancreat Surg. 2001;8:353–9.CrossRefGoogle Scholar
- 10.Mazzaferro V, Romito R, Schiavo M, et al. HCC Italian Task Force. Prevention of hepatocellular carcinoma recurrence with alpha-interferon after liver resection in HCV cirrhosis. Hepatology. 2006;44:1543–54.Google Scholar
- 17.ANRS collaborative study group on hepatocellular carcinoma (ANRS CO22 HEPATHER, CO12 CirVir and CO23 CUPILT cohorts). Lack of evidence of an effect of direct-acting antivirals on the recurrence of hepatocellular carcinoma: data from three ANRS cohorts. J Hepatol. 2016;65:734–40.Google Scholar
- 21.Liver Cancer Study Group of Japan General rules for the clinical and pathological study of primary liver cancer, 2008. 5th Japanese ed. Tokyo: Kanehara; 2008.Google Scholar
- 22.Sobin LH, Gospodarowicz MK, Wittekind CH, editors. TNM Classification of Malignant Tumours, 7th ed. New York: Wiley-Liss; 2009.Google Scholar