Comparison of improved prognosis between hepatitis B- and hepatitis C-related hepatocellular carcinoma

AimTreatment strategies for hepatocellular carcinoma (HCC) have been advanced. The aim of this study was to compare the change of the prognosis between hepatitis B-related HCC (B-HCC) and hepatitis C-related HCC (C-HCC) in the last two decades. MethodsWe enrolled 166 B-HCC patients who underwent percutaneous ablation between 1990 and 2009. Patients were divided into three groups according to the treatment time period: 1990-1995 (cohort 1, n=19), 1996-2002 (cohort 2, n=49) and 2003-2009 (cohort 3, n=98). We enrolled 1219 C-HCC patients who underwent percutaneous ablation during the same period (n=190, 413 and 616, respectively.). Interferon and nucleoside/nucleotide analog use was investigated. Prognosis was evaluated for each cohort using the Kaplan-Meier method and a multivariate Cox proportional hazard regression model. ResultsTwo (11%), 24 (49%) and 80 (82%) B-HCC patients received nucleoside/nucleotide analogs during the follow-up period in cohorts 1-3, respectively. Among them 1, 18 and 62 patients achieved viral remission, respectively. Thirty-four (18%), 35 (8%) and 84 (14%) C-HCC patients received interferon therapy, respectively. The 5-year B-HCC (P<0.001) survival rates were 52.6%, 61.1% and 81.6% for cohorts 1-3, respectively. However, the survival rates were 55.6%, 58.8% and 61.1% for C-HCC (P=0.12), respectively. The B-HCC prognosis improved dramatically (P<0.001) over time, whereas the prognosis of C-HCC improved moderately (P=0.01). ConclusionThe prognosis of B-HCC has improved dramatically over time, whereas that of C-HCC has improved moderately.