Impact of Sustained Virological Response to Interferon Therapy on Recurrence of Hepatitis C Virus-Related Hepatocellular Carcinoma

• Published in: Annals of surgical oncology 2017-10, Vol.24 (11), p.3196-3202
• Main Authors: Shinkawa, Hiroji, Hasegawa, Kiyoshi, Arita, Junichi, Akamatsu, Nobuhisa, Kaneko, Junichi, Sakamoto, Yoshihiro, Kokudo, Norihiro
• Format: Article
• Language: English
• Subjects: Aged; Antiviral Agents - therapeutic use; Carcinoma, Hepatocellular - complications; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - virology; Female; Follow-Up Studies; Hepacivirus - isolation & purification; Hepatitis C; Hepatitis C - complications; Hepatitis C - drug therapy; Hepatitis C - virology; Hepatobiliary Tumors; Hepatocellular carcinoma; Humans; Interferon; Interferons - therapeutic use; Liver cancer; Liver Neoplasms - complications; Liver Neoplasms - drug therapy; Liver Neoplasms - virology; Male; Medicine; Medicine & Public Health; Neoplasm Recurrence, Local - drug therapy; Neoplasm Recurrence, Local - virology; Oncology; Prognosis; Propensity Score; Surgery; Surgical Oncology; Survival; Survival Rate
• ISSN: 1068-9265; 1534-4681
• DOI: 10.1245/s10434-017-6008-y

Background Although achieving a sustained virological response (SVR) in hepatitis C virus (HCV) infection is recognized as improving liver function and reducing hepatocellular carcinoma (HCC) development, its impact on HCC recurrence is unclear. This study investigated how preoperative SVR achievement by interferon treatment affects HCC recurrence in patients undergoing hepatic resection. Methods The study subjects were 521 patients with HCV infection who underwent initial and curative hepatic resection for HCC. To adjust for confounding factors between the SVR and non-SVR groups, propensity score-matching analysis was performed. Results After propensity score matching, 45 of the 49 patients in the SVR group, and an equal number of the 472 patients in the non-SVR group, were matched. The two groups had similar distributions of clinicopathological characteristics. In the matched cohort, the 3-, 5-, and 7-year recurrence-free survival rates after surgery were 56, 45, and 37%, respectively, in the SVR group, and 34, 23, and 7.2%, respectively, in the non-SVR group ( p  = 0.033). Additionally, the 3-, 5-, and 7-year overall survival rates after surgery were 82, 80, and 75%, respectively, in the SVR group, and 78, 64, and 44%, respectively, in the non-SVR group ( p  = 0.065). The 1- and 2-year cumulative recurrence rates in the early phase showed no significant difference between the SVR and non-SVR groups ( p  = 0.27). however, the 3-, 5-, and 7-year cumulative recurrence rates in the late phase were 14, 32, and 43%, respectively, in the SVR group, and 33, 55, and 86%, respectively, in the non-SVR group ( p  = 0.037). Conclusion Achievement of SVR may reduce postoperative recurrence after hepatic resection.