Post-hepatectomy survival rates better in patients with SVR
Post-hepatectomy overall and hepatocellular carcinoma recurrence-free survival rates were significantly higher in patients with hepatitis C who achieved sustained virologic response with pegylated IFN plus ribavirin treatment compared with patients who did not.
“Among patients with HCV infection-related HCC following hepatectomy, the prognosis of the SVR group was better than that of the non-SVR group,” Sho Okimoto, MD, from the department of gastroenterology and transplant surgery, Hiroshima University, Japan, and colleagues wrote. “This may be explained by the fact that the preoperative liver function in the SVR group was significantly better than that in the non-SVR group.”
Between January 2005 and December 2014, 349 patients with HCV-associated HCC underwent an initial radical hepatectomy and were enrolled in the study. Sixty-eight patients developed HCC after achieving SVR and 281 developed HCC without achieving SVR. Those in the SVR group were significantly younger (P = .01), were mostly men (P < .01) and had a higher alcohol intake (P < .05) vs. the non-SVR group.
Compared with the non-SVR group, the SVR group had better preoperative liver function indicators (P < .01), post-hepatectomy overall (P < .01) and HCC recurrence-free survival rates (P < .05), and better liver function at the time of recurrence (P < .01). Further, more patients in the SVR group were selected for surgery than in the non-SVR group (P < .01).
Significant risk factors related to recurrence-free survival in the SVR group included aminotransferase levels of 25 IU/L or greater (P = .01), an ICGR-15 of 20% or less (P < .05), hepatic vascular invasion (P < .05), and an interval of 30 months or less between achieving SVR and hepatectomy (P < .01).
Significant risk factors related to recurrence-free survival in the non-SVR group included alanine aminotransferase levels of 50 IU/L or greater (P = .01), albumin levels of less than 4 g/dL (P < .01), alpha-fetoprotein levels of 10 ng/mL or greater (P < .01), a tumor size of 20 mm or greater (P = .01), the presence of multiple tumors (P < .01), and liver fibrosis (P < .01).
“It is unknown whether the anti-hepatocarcinogenic effects of DAA agents will be similar to that of IFN-based therapy. A limitation of this study is that it did not include patients who received DAA therapy,” the researchers wrote. “Therefore, future prospective studies that include additional cases with similar clinical backgrounds will be required to address this issue.”
Disclosure: Healio.com/Hepatology was unable to determine the researchers’ relevant financial disclosures at the time of publication.