Junichi Shindoh1, Kiyoshi Hasegawa2, Nobuyuki Takemura2, Kiyohiko Omichi2, Takeaki Ishizawa2, Taku Aoki2, Yoshihiro Sakamoto2, Yasuhiko Sugawara2, Norihiro Kokudo3. 1. Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. shindou-tky@umin.ac.jp. 2. Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. 3. Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. KOKUDO-2SU@h.u-tokyo.ac.jp.
Abstract
PURPOSE: To clarify the prognostic impact of the hepatitis C virus (HCV) genotype after curative resection for hepatocellular carcinoma (HCC). METHODS: A total of 199 patients who underwent a curative hepatic resection for HCV-related HCC were reviewed. The clinical outcomes were compared between patients infected with HCV genotype 1b (n = 160) and those infected with other genotypes (n = 39). RESULTS: With a comparable median HCV viral load (6.0 vs. 5.8 log10 IU/mL, p = 0.17), the 3-year recurrence-free survival (RFS) rates (25 vs. 20 %, p = 0.65) and the 5-year overall survival (OS) rates (72 vs. 65 %, p = 0.73) were similar between the two groups. A multivariate analysis confirmed that HCV viral load of +1.0 log10 IU/mL [hazard ratio (HR), 1.48], major vascular invasion (HR, 3.20), recurrent tumor (HR, 1.77), and preoperative des-gamma carboxyprothrombin level >40 mAu/mL (HR, 1.64) were independent predictors of tumor recurrence, while the HCV genotype was not a significant risk factor. When the population was stratified according to the HCV viral load, a significant difference was observed in the RFS rate for both genotype 1b (p = 0.003) and the other genotypes (p = 0.037) at HCV viral load of 5.3 log10 IU/mL. CONCLUSIONS: The HCV genotype does not affect the surgical outcomes of patients with HCC. A lower HCV viral load is advantageous regardless of the HCV genotype.
PURPOSE: To clarify the prognostic impact of the hepatitis C virus (HCV) genotype after curative resection for hepatocellular carcinoma (HCC). METHODS: A total of 199 patients who underwent a curative hepatic resection for HCV-related HCC were reviewed. The clinical outcomes were compared between patients infected with HCV genotype 1b (n = 160) and those infected with other genotypes (n = 39). RESULTS: With a comparable median HCV viral load (6.0 vs. 5.8 log10 IU/mL, p = 0.17), the 3-year recurrence-free survival (RFS) rates (25 vs. 20 %, p = 0.65) and the 5-year overall survival (OS) rates (72 vs. 65 %, p = 0.73) were similar between the two groups. A multivariate analysis confirmed that HCV viral load of +1.0 log10 IU/mL [hazard ratio (HR), 1.48], major vascular invasion (HR, 3.20), recurrent tumor (HR, 1.77), and preoperative des-gamma carboxyprothrombin level >40 mAu/mL (HR, 1.64) were independent predictors of tumor recurrence, while the HCV genotype was not a significant risk factor. When the population was stratified according to the HCV viral load, a significant difference was observed in the RFS rate for both genotype 1b (p = 0.003) and the other genotypes (p = 0.037) at HCV viral load of 5.3 log10 IU/mL. CONCLUSIONS: The HCV genotype does not affect the surgical outcomes of patients with HCC. A lower HCV viral load is advantageous regardless of the HCV genotype.
Authors: S Kubo; K Hirohashi; H Tanaka; T Tsukamoto; T Shuto; T Ikebe; T Yamamoto; K Wakasa; S Nishiguchi; T Kuroki; H Kinoshita Journal: World J Surg Date: 2000-12 Impact factor: 3.352
Authors: H Tsukuma; T Hiyama; S Tanaka; M Nakao; T Yabuuchi; T Kitamura; K Nakanishi; I Fujimoto; A Inoue; H Yamazaki Journal: N Engl J Med Date: 1993-06-24 Impact factor: 91.245
Authors: T Takayama; M Makuuchi; S Hirohashi; M Sakamoto; J Yamamoto; K Shimada; T Kosuge; S Okada; K Takayasu; S Yamasaki Journal: Hepatology Date: 1998-11 Impact factor: 17.425