direct acting antivirals;
hepatocellular carcinoma;
hepatitis C virus;
recurrence;
time interval;
SUSTAINED VIROLOGICAL RESPONSE;
EARLY TUMOR RECURRENCE;
UNEXPECTED HIGH-INCIDENCE;
CIRRHOTIC-PATIENTS;
THERAPY;
RISK;
HCC;
CHEMOEMBOLIZATION;
DECREASES;
ABLATION;
D O I:
10.1097/MEG.0000000000001972
中图分类号:
R57 [消化系及腹部疾病];
学科分类号:
摘要:
Background Conflicting studies were proposed either suggested or denied the relationship between early hepatocellular carcinoma (HCC) recurrence and the use of direct-acting antivirals (DAAs) for chronic hepatitis C management Aim of the study To evaluate HCC recurrence rate post-DAAs and potential predictive factors. Study This prospective cohort study included all HCC patients achieved complete response attending our multidisciplinary HCC clinic, Cairo University, from November 2013 to February 2018. Group I (60 patients) who received DAAs after HCC ablation and group II (273 patients) who were DAAs-untreated. We studied factors that could play a role in HCC recurrence. Results The sustained virological response rate was 88.3% among DAA-treated patients. HCC recurrence rate was 45% in the post-DAA group vs. 19% in the non-DAAs group; P < 0.001. Mean survival was significantly higher in the post-DAA group (34.23 +/- 16.16 vs. 23.92 +/- 13.99 months respectively; P value <0.001). There was a significant correlation between HCC recurrence rate and age, male gender, mean size of tumors and time interval between complete HCC ablation and occurrence of HCC recurrence. Conclusion Our study reports high rate of HCC recurrence post-DAA therapy in patients treated with transarterial chemoembolization but not in those treated with curative measures. DAA therapy after curative treatment for HCC led to significantly earlier HCC recurrence, which correlated with specific clinic-pathologic features in our prospective single-institution study. However, future independent prospective randomized studies are warranted to evaluate this correlation which may lead to a change in the current standard-of-care approach to patients with hepatitis C virus-related HCC.
机构:
AO Villa Sofia Cervello, UOC Med Intern, Palermo, ItalyUniv Palermo, Dipartimento Promoz Salute Materno Infantile Med, Sect Gastroenterol & Hepatol, Palermo, Italy
机构:
Univ Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, ItalyUniv Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, Italy
Buonfiglioli, Federica
Scuteri, Alessandra
论文数: 0引用数: 0
h-index: 0
机构:
St Orsola Marcello Malpighi Hosp, Dept Digest Dis, Bologna, ItalyUniv Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, Italy
Scuteri, Alessandra
Crespi, Cristina
论文数: 0引用数: 0
h-index: 0
机构:
St Orsola Marcello Malpighi Hosp, Dept Digest Dis, Bologna, ItalyUniv Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, Italy
Crespi, Cristina
Bolondi, Luigi
论文数: 0引用数: 0
h-index: 0
机构:
Univ Bologna, Dept Med & Surg Sci DIMEC, I-40126 Bologna, ItalyUniv Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, Italy
Bolondi, Luigi
Caraceni, Paolo
论文数: 0引用数: 0
h-index: 0
机构:
Univ Bologna, Dept Med & Surg Sci DIMEC, I-40126 Bologna, ItalyUniv Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, Italy
Caraceni, Paolo
Foschi, Francesco Giuseppe
论文数: 0引用数: 0
h-index: 0
机构:
Osped Faenza, Div Internal Med, Faenza, ItalyUniv Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, Italy
Foschi, Francesco Giuseppe
Lenzi, Marco
论文数: 0引用数: 0
h-index: 0
机构:
Univ Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, ItalyUniv Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, Italy
Lenzi, Marco
Mazzella, Giuseppe
论文数: 0引用数: 0
h-index: 0
机构:
Univ Bologna, Dept Med & Surg Sci DIMEC, I-40126 Bologna, ItalyUniv Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, Italy
Mazzella, Giuseppe
Verucchi, Gabriella
论文数: 0引用数: 0
h-index: 0
机构:
Univ Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, ItalyUniv Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, Italy
Verucchi, Gabriella
Andreone, Pietro
论文数: 0引用数: 0
h-index: 0
机构:
Univ Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, ItalyUniv Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, Italy
Andreone, Pietro
Brillanti, Stefano
论文数: 0引用数: 0
h-index: 0
机构:
Univ Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, ItalyUniv Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, Italy
机构:
Helwan Univ, Endem Med Dept, Fac Med, Cairo, EgyptHelwan Univ, Endem Med Dept, Fac Med, Cairo, Egypt
El Kassas, M.
Funk, A. L.
论文数: 0引用数: 0
h-index: 0
机构:
Inst Pasteur, Emerging Dis Epidemiol Unit, Paris, FranceHelwan Univ, Endem Med Dept, Fac Med, Cairo, Egypt
Funk, A. L.
论文数: 引用数:
h-index:
机构:
Salaheldin, M.
论文数: 引用数:
h-index:
机构:
Shimakawa, Y.
论文数: 引用数:
h-index:
机构:
Eltabbakh, M.
Jean, K.
论文数: 0引用数: 0
h-index: 0
机构:
Conservatoire Natl Arts & Metiers, Lab MESuRS, EA 4628, Paris, France
Conservatoire Natl Arts & Metiers, Inst Pasteur, Unite PACRI, Paris, FranceHelwan Univ, Endem Med Dept, Fac Med, Cairo, Egypt
Jean, K.
El Tahan, A.
论文数: 0引用数: 0
h-index: 0
机构:
New Cairo Viral Hepatitis Treatment Unit, Cairo, EgyptHelwan Univ, Endem Med Dept, Fac Med, Cairo, Egypt
El Tahan, A.
Sweedy, A. T.
论文数: 0引用数: 0
h-index: 0
机构:
New Cairo Viral Hepatitis Treatment Unit, Cairo, EgyptHelwan Univ, Endem Med Dept, Fac Med, Cairo, Egypt
Sweedy, A. T.
Afify, S.
论文数: 0引用数: 0
h-index: 0
机构:
Natl Hepatol & Trop Med Res Inst, Cairo, EgyptHelwan Univ, Endem Med Dept, Fac Med, Cairo, Egypt
Afify, S.
论文数: 引用数:
h-index:
机构:
Youssef, N. F.
Esmat, G.
论文数: 0引用数: 0
h-index: 0
机构:
Cairo Univ, Fac Med, Endem Med & Hepatogastroenterol Dept, Cairo, EgyptHelwan Univ, Endem Med Dept, Fac Med, Cairo, Egypt
Esmat, G.
Fontanet, A.
论文数: 0引用数: 0
h-index: 0
机构:
Inst Pasteur, Emerging Dis Epidemiol Unit, Paris, France
Conservatoire Natl Arts & Metiers, Inst Pasteur, Unite PACRI, Paris, FranceHelwan Univ, Endem Med Dept, Fac Med, Cairo, Egypt
机构:
AO Villa Sofia Cervello, UOC Med Intern, Palermo, ItalyUniv Palermo, Dipartimento Promoz Salute Materno Infantile Med, Sect Gastroenterol & Hepatol, Palermo, Italy
机构:
Univ Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, ItalyUniv Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, Italy
Buonfiglioli, Federica
Scuteri, Alessandra
论文数: 0引用数: 0
h-index: 0
机构:
St Orsola Marcello Malpighi Hosp, Dept Digest Dis, Bologna, ItalyUniv Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, Italy
Scuteri, Alessandra
Crespi, Cristina
论文数: 0引用数: 0
h-index: 0
机构:
St Orsola Marcello Malpighi Hosp, Dept Digest Dis, Bologna, ItalyUniv Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, Italy
Crespi, Cristina
Bolondi, Luigi
论文数: 0引用数: 0
h-index: 0
机构:
Univ Bologna, Dept Med & Surg Sci DIMEC, I-40126 Bologna, ItalyUniv Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, Italy
Bolondi, Luigi
Caraceni, Paolo
论文数: 0引用数: 0
h-index: 0
机构:
Univ Bologna, Dept Med & Surg Sci DIMEC, I-40126 Bologna, ItalyUniv Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, Italy
Caraceni, Paolo
Foschi, Francesco Giuseppe
论文数: 0引用数: 0
h-index: 0
机构:
Osped Faenza, Div Internal Med, Faenza, ItalyUniv Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, Italy
Foschi, Francesco Giuseppe
Lenzi, Marco
论文数: 0引用数: 0
h-index: 0
机构:
Univ Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, ItalyUniv Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, Italy
Lenzi, Marco
Mazzella, Giuseppe
论文数: 0引用数: 0
h-index: 0
机构:
Univ Bologna, Dept Med & Surg Sci DIMEC, I-40126 Bologna, ItalyUniv Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, Italy
Mazzella, Giuseppe
Verucchi, Gabriella
论文数: 0引用数: 0
h-index: 0
机构:
Univ Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, ItalyUniv Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, Italy
Verucchi, Gabriella
Andreone, Pietro
论文数: 0引用数: 0
h-index: 0
机构:
Univ Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, ItalyUniv Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, Italy
Andreone, Pietro
Brillanti, Stefano
论文数: 0引用数: 0
h-index: 0
机构:
Univ Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, ItalyUniv Bologna, Dept Med & Surg Sci DIMEC, Res Ctr Study Hepatitis, I-40126 Bologna, Italy
机构:
Helwan Univ, Endem Med Dept, Fac Med, Cairo, EgyptHelwan Univ, Endem Med Dept, Fac Med, Cairo, Egypt
El Kassas, M.
Funk, A. L.
论文数: 0引用数: 0
h-index: 0
机构:
Inst Pasteur, Emerging Dis Epidemiol Unit, Paris, FranceHelwan Univ, Endem Med Dept, Fac Med, Cairo, Egypt
Funk, A. L.
论文数: 引用数:
h-index:
机构:
Salaheldin, M.
论文数: 引用数:
h-index:
机构:
Shimakawa, Y.
论文数: 引用数:
h-index:
机构:
Eltabbakh, M.
Jean, K.
论文数: 0引用数: 0
h-index: 0
机构:
Conservatoire Natl Arts & Metiers, Lab MESuRS, EA 4628, Paris, France
Conservatoire Natl Arts & Metiers, Inst Pasteur, Unite PACRI, Paris, FranceHelwan Univ, Endem Med Dept, Fac Med, Cairo, Egypt
Jean, K.
El Tahan, A.
论文数: 0引用数: 0
h-index: 0
机构:
New Cairo Viral Hepatitis Treatment Unit, Cairo, EgyptHelwan Univ, Endem Med Dept, Fac Med, Cairo, Egypt
El Tahan, A.
Sweedy, A. T.
论文数: 0引用数: 0
h-index: 0
机构:
New Cairo Viral Hepatitis Treatment Unit, Cairo, EgyptHelwan Univ, Endem Med Dept, Fac Med, Cairo, Egypt
Sweedy, A. T.
Afify, S.
论文数: 0引用数: 0
h-index: 0
机构:
Natl Hepatol & Trop Med Res Inst, Cairo, EgyptHelwan Univ, Endem Med Dept, Fac Med, Cairo, Egypt
Afify, S.
论文数: 引用数:
h-index:
机构:
Youssef, N. F.
Esmat, G.
论文数: 0引用数: 0
h-index: 0
机构:
Cairo Univ, Fac Med, Endem Med & Hepatogastroenterol Dept, Cairo, EgyptHelwan Univ, Endem Med Dept, Fac Med, Cairo, Egypt
Esmat, G.
Fontanet, A.
论文数: 0引用数: 0
h-index: 0
机构:
Inst Pasteur, Emerging Dis Epidemiol Unit, Paris, France
Conservatoire Natl Arts & Metiers, Inst Pasteur, Unite PACRI, Paris, FranceHelwan Univ, Endem Med Dept, Fac Med, Cairo, Egypt