Chung-Feng Huang1, Hsueh-Chou Lai2, Chi-Yi Chen3, Kuo-Chih Tseng4, Hsing-Tao Kuo5, Chao-Hung Hung6, Jing-Houng Wang7, Jyh-Jou Chen8, Pei-Lun Lee8, Rong-Nan Chien9, Chi-Chieh Yang10, Gin-Ho Lo11, Chi-Ming Tai11, Chih-Wen Lin11, Jia-Horng Kao12,13, Chun-Jen Liu12,13, Chen-Hua Liu12,13, Sheng-Lei Yan14, Ming-Jong Bair15, Chun-Yen Lin9, Wei-Wen Su16, Cheng-Hsin Chu17, Chih-Jen Chen17, Shui-Yi Tung6, Ching-Chu Lo18, Pin-Nan Cheng19, Yen-Cheng Chiu19, Chia-Chi Wang20, Jin-Shiung Cheng21, Wei-Lun Tsai21, Han-Chieh Lin22, Yi-Hsiang Huang22,23, Ming-Lun Yeh1, Jee-Fu Huang1, Chia-Yen Dai1, Wan-Long Chuang1, Pei-Chien Tsai1, Cheng-Yuan Peng2, Ming-Lung Yu1. 1. Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. 2. Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, School of Medicine, China Medical University, Taichung, Taiwan. 3. Department of Internal Medicine, Chiayi Christian Hospital, Chiayi, Taiwan. 4. Department of Gastroenterology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan. 5. Division of Hepato-gastroenterology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan. 6. Division of Hepatogastroenterology, Department of Internal Medicine, ChiaYi Chang Gung Memorial Hospital, Chiayi, Taiwan. 7. Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan. 8. Division of Gastroenterology and Hepatology, Chi-Mei Medical Center, Liouying, Tainan. 9. Division of Hepatology, Department of Gastroenterology and Hepatology, Linkou Medical Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan. 10. Division of Gastroenterology, Department of Internal Medicine, Show Chwan Memorial Hospital, Changhua, Taiwan. 11. Division of Gastroenterology and Hepatology, Department of Medicine, E-Da Hospital, School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan. 12. Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan. 13. Division of Gastroenterology and Hepatology, the National Taiwan University Hospital, Taipei, Taiwan. 14. Division of Gastroenterology, Department of Internal Medicine, Chang Bing Show-Chwan Memorial Hospital, Changhua City, Taiwan. 15. Division of Gastroenterology, Department of Internal Medicine, Taitung Mackay Memorial Hospital, Taitung City, Taiwan. 16. Division of Gastroenterology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan. 17. Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan. 18. Department of Internal Medicine, St. Martin De Porres Hospital, Daya, Chiayi, Taiwan. 19. Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. 20. Division of Gastroenterology, Department of Internal Medicine, Taipei Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, New Taipei City, Taiwan. 21. Division of Gastroenterology and Hepatology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. 22. Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. 23. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
Abstract
INTRODUCTION: Chronic hepatitis C virus (HCV) infection is associated with nonhepatocellular carcinoma malignancies. We aimed to evaluate whether achieving a sustained virological response (SVR, defined as HCV RNA seronegativity throughout posttreatment 24-week follow-up) could reduce the risk of non-hepatocellular carcinoma malignancy in a real-world nationwide Taiwanese Chronic Hepatitis C Cohort (T-COACH). METHODS: A total of 10,714 patients with chronic hepatitis C who had received interferon-based therapy (8,186 SVR and 2,528 non-SVR) enrolled in T-COACH and were linked to the National Cancer Registry database for the development of 12 extrahepatic malignancies, including those with potential associations with HCV and with the top-ranking incidence in Taiwan, over a median follow-up period was 3.79 years (range, 0-16.44 years). RESULTS: During the 44,354 person-years of follow-up, 324 (3.02%) patients developed extrahepatic malignancies, without a difference between patients with and without SVR (annual incidence: 0.69% vs 0.87%, respectively). Compared with patients with SVR, patients without SVR had a significantly higher risk of gastric cancer (0.10% vs 0.03% per person-year, P = 0.004) and non-Hodgkin lymphoma (NHL) (0.08% vs 0.03% per person-year, respectively, P = 0.03). When considering death as a competing risk, non-SVR was independently associated with gastric cancer (hazard ratio [HR]/95% confidence intervals [CIs]: 3.29/1.37-7.93, P = 0.008). When patients were stratified by age, the effect of SVR in reducing gastric cancer (HR/CI: 0.30/0.11-0.83) and NHL (HR/CI: 0.28/0.09-0.85) was noted only in patients aged <65 years but not those aged >65 years. DISCUSSION: HCV eradication reduced the risk of gastric cancer and NHL, in particular among younger patients, indicating that patients with chronic hepatitis C should be treated as early as possible.
INTRODUCTION:Chronic hepatitis C virus (HCV) infection is associated with nonhepatocellular carcinoma malignancies. We aimed to evaluate whether achieving a sustained virological response (SVR, defined as HCV RNA seronegativity throughout posttreatment 24-week follow-up) could reduce the risk of non-hepatocellular carcinoma malignancy in a real-world nationwide Taiwanese Chronic Hepatitis C Cohort (T-COACH). METHODS: A total of 10,714 patients with chronic hepatitis C who had received interferon-based therapy (8,186 SVR and 2,528 non-SVR) enrolled in T-COACH and were linked to the National Cancer Registry database for the development of 12 extrahepatic malignancies, including those with potential associations with HCV and with the top-ranking incidence in Taiwan, over a median follow-up period was 3.79 years (range, 0-16.44 years). RESULTS: During the 44,354 person-years of follow-up, 324 (3.02%) patients developed extrahepatic malignancies, without a difference between patients with and without SVR (annual incidence: 0.69% vs 0.87%, respectively). Compared with patients with SVR, patients without SVR had a significantly higher risk of gastric cancer (0.10% vs 0.03% per person-year, P = 0.004) and non-Hodgkin lymphoma (NHL) (0.08% vs 0.03% per person-year, respectively, P = 0.03). When considering death as a competing risk, non-SVR was independently associated with gastric cancer (hazard ratio [HR]/95% confidence intervals [CIs]: 3.29/1.37-7.93, P = 0.008). When patients were stratified by age, the effect of SVR in reducing gastric cancer (HR/CI: 0.30/0.11-0.83) and NHL (HR/CI: 0.28/0.09-0.85) was noted only in patients aged <65 years but not those aged >65 years. DISCUSSION: HCV eradication reduced the risk of gastric cancer and NHL, in particular among younger patients, indicating that patients with chronic hepatitis C should be treated as early as possible.
Authors: Maryam Darvishian; Zahid A Butt; Stanley Wong; Eric M Yoshida; Jaskaran Khinda; Michael Otterstatter; Amanda Yu; Mawuena Binka; Carmine Rossi; Geoff McKee; Margo Pearce; Maria Alvarez; Jason Wong; Darrel Cook; Troy Grennan; Jane Buxton; Mark Tyndall; Ryan Woods; Mel Krajden; Parveen Bhatti; Naveed Z Janjua Journal: Ther Adv Med Oncol Date: 2021-02-11 Impact factor: 8.168