Ana Lleo1, Andrea Aglitti2, Alessio Aghemo1, Patrick Maisonneuve3, Savino Bruno1, Marcello Persico4. 1. Humanitas University, Department of Biomedical Sciences, Milan, Italy; Division of Internal Medicine and Hepatology, Humanitas Clinical and Research Center, Milan, Italy. 2. Internal Medicine and Hepatology Unit, University of Salerno, Salerno, Italy. 3. Division of Epidemiology and Biostatistics, IEO, European Institute of Oncology IRCCS, Milan, Italy. 4. Internal Medicine and Hepatology Unit, University of Salerno, Salerno, Italy. Electronic address: mpersico@unisa.it.
Abstract
BACKGROUND: Despite the dramatic improvement in viral eradication rates that has been reached with direct antiviral agents (DAAs), the real benefit of viral eradication after DAAs on hepatocellular carcinoma (HCC) development is still controversial. AIM: To prospectively assess the risk of HCC occurrence and early recurrence in a large cohort of DAA-treated HCV-cirrhotic patients and to identify potential predictors of HCC development. METHODS: We analyzed data prospectively collected from 1927 consecutive HCV-infected cirrhotic patients treated with DAA from January to December 2015 in 10 tertiary liver centers in Italy and followed-up for one year after therapy. 161 patients had a previous HCC. RESULTS: 38/161 subjects developed tumor recurrence during the follow-up (recurrence rate = 24.8 per 100-year), patients with SVR had a significantly lower rate of recurrence. Lack of SVR and alpha-fetoprotein (AFP) were independent predictors of HCC recurrence. 50/1766 patients without a previous HCC history developed HCC during follow-up (incidence rate = 2.4 per 100-year). Lack of SVR was the strongest predictor of HCC development. Furthermore, patients with SVR and no stigmata of portal hypertension have a lower incidence rate of HCC (1.0 per 100-year). CONCLUSIONS: SVR is associated with a significant decrease of recurrent or de novo HCC. Baseline AFP and signs of portal hypertension can help to stratify the risk of HCC.
BACKGROUND: Despite the dramatic improvement in viral eradication rates that has been reached with direct antiviral agents (DAAs), the real benefit of viral eradication after DAAs on hepatocellular carcinoma (HCC) development is still controversial. AIM: To prospectively assess the risk of HCC occurrence and early recurrence in a large cohort of DAA-treated HCV-cirrhoticpatients and to identify potential predictors of HCC development. METHODS: We analyzed data prospectively collected from 1927 consecutive HCV-infected cirrhoticpatients treated with DAA from January to December 2015 in 10 tertiary liver centers in Italy and followed-up for one year after therapy. 161 patients had a previous HCC. RESULTS: 38/161 subjects developed tumor recurrence during the follow-up (recurrence rate = 24.8 per 100-year), patients with SVR had a significantly lower rate of recurrence. Lack of SVR and alpha-fetoprotein (AFP) were independent predictors of HCC recurrence. 50/1766 patients without a previous HCC history developed HCC during follow-up (incidence rate = 2.4 per 100-year). Lack of SVR was the strongest predictor of HCC development. Furthermore, patients with SVR and no stigmata of portal hypertension have a lower incidence rate of HCC (1.0 per 100-year). CONCLUSIONS: SVR is associated with a significant decrease of recurrent or de novo HCC. Baseline AFP and signs of portal hypertension can help to stratify the risk of HCC.
Authors: Ekram W Abd El-Wahab; Waleed M Abd Elgawad; Mohamed S Abdelaziz; Ashraf I Mikheal; Hanan Z Shatat Journal: Am J Trop Med Hyg Date: 2022-02-28 Impact factor: 3.707
Authors: Eric Lawitz; Fred Poordad; Julio A Gutierrez; Maria Beumont; Greet Beets; Ann Vandevoorde; Pieter Van Remoortere; Donghan Luo; Leen Vijgen; Veerle Van Eygen; Mohamed Gamil Journal: Health Sci Rep Date: 2020-02-22