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Long-term assessment of recurrence of hepatocellular carcinoma in patients with chronic hepatitis C after viral cure by direct-acting antivirals.
- Source :
-
Journal of gastroenterology and hepatology [J Gastroenterol Hepatol] 2022 Jan; Vol. 37 (1), pp. 190-199. Date of Electronic Publication: 2021 Aug 23. - Publication Year :
- 2022
-
Abstract
- Background and Aim: Early hepatocellular carcinoma (HCC) recurrence is common, even after achieving hepatitis C virus (HCV) cure. This study was carried out to assess the long-term trends and predictors of recurrence after HCV cure by direct-acting antivirals (DAAs).<br />Methods: This retrospective, multicenter cohort study enrolled 365 consecutive patients with chronic hepatitis C who required HCC treatment following sustained viral response (SVR) by DAA administration. Patients with HCC recurrence before SVR were excluded. Late HCC recurrence and its predictors beyond the post-treatment early phase (24 weeks after SVR) were evaluated.<br />Results: The data of 326 patients were available for the final analysis. The median follow-up duration from SVR determination was 2.7 years. Median age was 74, and 220 (67.5%) were 70 or over. The corresponding 5-year cumulative HCC recurrence rates of previous curative and palliative treatment groups were 45.4% and 65.7%, respectively (log-rank test: P < 0.001). Cox regression multivariable analysis revealed that cirrhosis (hazard ratio [HR] 1.85, P = 0.021), the number of HCC nodules (≥ 2) (HR 1.52, P = 0.031), and previous palliative HCC treatment (HR 1.71, P = 0.012) were independent predictors of late recurrence, in addition to the predictors of early recurrence; AFP > 7 ng/mL at 12 weeks after DAA administration, time from HCC complete response (CR) to DAA initiation (< 1 year), and the number of HCC treatments necessary to achieve CR (≥ 2).<br />Conclusions: The evaluation of fibrosis and characteristics of the previous HCC would allow for better HCC recurrence stratification, which would be helpful for developing long-term surveillance strategies.<br /> (© 2021 The Authors. Journal of Gastroenterology and Hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)
- Subjects :
- Antiviral Agents therapeutic use
Humans
Recurrence
Retrospective Studies
Sustained Virologic Response
Treatment Outcome
Carcinoma, Hepatocellular pathology
Carcinoma, Hepatocellular virology
Hepatitis C, Chronic complications
Hepatitis C, Chronic drug therapy
Liver Neoplasms pathology
Liver Neoplasms virology
Subjects
Details
- Language :
- English
- ISSN :
- 1440-1746
- Volume :
- 37
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of gastroenterology and hepatology
- Publication Type :
- Academic Journal
- Accession number :
- 34374128
- Full Text :
- https://doi.org/10.1111/jgh.15659