The Impact of Direct-Acting Antiviral Therapy on the Risk of Recurrence after Curative Resection in Patients with Hepatitis-C-Virus-Related Early Stage Hepatocellular Carcinoma

被引:7
作者
Chen, Yu-Syuan [1 ]
Huang, Kuo-Hsuan [2 ]
Wang, Pei-Ming [3 ]
Chuang, Ching-Hui [4 ]
Yong, Chee-Chien [5 ,6 ]
Liu, Yueh-Wei [5 ,6 ]
Huang, Pao-Yuan [2 ]
Yao, Chih-Chien [2 ]
Lin, Yen-Po [1 ]
Tsai, Ming-Chao [2 ,7 ]
机构
[1] Chung Shan Med Univ, Sch Med, Taichung 40201, Taiwan
[2] Chang Gung Univ, Kaohsiung Chang Gung Mem Hosp, Dept Internal Med, Div Hepatogastroenterol,Coll Med, Kaohsiung 83301, Taiwan
[3] Kaohsiung Chang Gung Mem Hosp, Dept Family Med, Kaohsiung 83301, Taiwan
[4] Meiho Univ, Dept Nursing, Pingtung 91202, Taiwan
[5] Chang Gung Univ, Kaohsiung Chang Gung Mem Hosp, Liver Transplantat Ctr, Coll Med, Kaohsiung 83301, Taiwan
[6] Chang Gung Univ, Kaohsiung Chang Gung Mem Hosp, Dept Surg, Coll Med, Kaohsiung 83301, Taiwan
[7] Chang Gung Univ, Coll Med, Grad Inst Clin Med Sci, Taoyuan 83301, Taiwan
来源
MEDICINA-LITHUANIA | 2022年 / 58卷 / 02期
关键词
DAA; hepatocellular carcinoma; recurrence; SUSTAINED VIROLOGICAL RESPONSE; VIRAL RESPONSE; PLUS RIBAVIRIN; LIVER-CANCER; SOFOSBUVIR; ASSOCIATION; LEDIPASVIR; INFECTION; SURVIVAL;
D O I
10.3390/medicina58020259
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background and Objectives: The impact of direct-acting antiviral (DAA)-based regimens on the recurrence of hepatocellular carcinoma (HCC) after successful curative hepatectomy is controversial. Aims: This study aimed to assess the association between DAAs treatment and recurrence risk in HCC after resection. Materials and Methods: We retrospectively assessed 152 cases of early stage (BCLC stage 0/A) hepatitis C virus (HCV)-related HCC (HCV-HCC) that underwent resection with curative intent between 2001 and 2019 at Kaohsiung Chang Gung Memorial Hospital; 48 cases achieved a sustained virological response (SVR) by DAA, and 104 cases were not treated with any antiviral therapy (non-treatment group). Recurrence-free survival (RFS) following curative resection was analyzed by using the log-rank test and Kaplan-Meier method. A Cox proportional hazards model was used to analyze the factors that impacted RFS and OS. Results: Five patients (10.4%) experienced HCC recurrence after DAA therapy. The cumulative HCC recurrence rate was significantly lower in the DAA group than the non-treatment group (p < 0.001). Multivariate analysis revealed a significant difference in RFS between the non-treatment group and DAA group (p = 0.001; hazard ratio (HR), 4.978; 95% CI, 1.976-12.542); liver cirrhosis (p = 0.005; HR, 2.062; 95% CI, 1.247-3.410), microvascular invasion (p = 0.001; HR, 2.331; 95% CI, 1.408-3.860) and AFP > 15 ng/mL (p = 0.022; HR, 1.799; 95% CI, 1.089-2.970) were also independent factors for HCC recurrence. ALBI stage II/III (p = 0.005; HR, 3.249; 95% CI, 1.418-7.443) and microvascular invasion (p < 0.001; HR, 4.037 95% CI, 2.071-7.869) were independent factors for OS; no significant difference in OS was observed between the DAA and no DAA treatment groups. Conclusions: DAA treatment could reduce the risk of recurrence after curative treatment for early stage HCC.
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页数:13
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