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

• Published in: Medicina (Kaunas, Lithuania) Lithuania), 2022-02, Vol.58 (2), p.259
• Main Authors: Chen, Yu-Syuan, Huang, Kuo-Hsuan, Wang, Pei-Ming, Chuang, Ching-Hui, Yong, Chee-Chien, Liu, Yueh-Wei, Huang, Pao-Yuan, Yao, Chih-Chien, Lin, Yen-Po, Tsai, Ming-Chao
• Format: Article
• Language: English
• Subjects: Antiviral Agents - therapeutic use; Carcinoma, Hepatocellular - drug therapy; DAA; Genotype & phenotype; Hepacivirus; Hepatitis C; Hepatitis C - complications; Hepatitis C - drug therapy; Hepatitis C - epidemiology; Hepatitis C, Chronic - drug therapy; hepatocellular carcinoma; Humans; Liver cancer; Liver cirrhosis; Liver Neoplasms - drug therapy; Magnetic resonance imaging; Medical prognosis; Mortality; Neoplasm Recurrence, Local - drug therapy; Neoplasm Recurrence, Local - epidemiology; recurrence; Retrospective Studies; Surgery; Surgical outcomes
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina58020259

: 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. : 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. : 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 ( < 0.001). Multivariate analysis revealed a significant difference in RFS between the non-treatment group and DAA group ( = 0.001; hazard ratio (HR), 4.978; 95% CI, 1.976-12.542); liver cirrhosis ( = 0.005; HR, 2.062; 95% CI, 1.247-3.410), microvascular invasion ( = 0.001; HR, 2.331; 95% CI, 1.408-3.860) and AFP > 15 ng/mL ( = 0.022; HR, 1.799; 95% CI, 1.089-2.970) were also independent factors for HCC recurrence. ALBI stage II/III ( = 0.005; HR, 3.249; 95% CI, 1.418-7.443) and microvascular invasion ( < 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. : DAA treatment could reduce the risk of recurrence after curative treatment for early stage HCC.