Yasuhito Tanaka1, Eiichi Ogawa2, Chung-Feng Huang3,4, Hidenori Toyoda5, Dae Won Jun6, Cheng-Hao Tseng7, Yao-Chun Hsu7, Masaru Enomoto8, Hirokazu Takahashi9,10, Norihiro Furusyo2, Ming-Lun Yeh3,4, Etsuko Iio1, Satoshi Yasuda5, Carla Pui-Mei Lam11, Dong Hyun Lee12, Hiroaki Haga13, Eileen L Yoon14, Sang Bong Ahn15, Grace Wong16,17, Makoto Nakamuta18, Hideyuki Nomura19, Pei-Chien Tsai3,4, Jang Han Jung20, Do Seon Song21, Hansen Dang22, Mayumi Maeda22, Linda Henry22, Ramsey Cheung22,23, Man-Fung Yuen11,24, Yoshiyuki Ueno13, Yuichiro Eguchi9, Akihiro Tamori8, Ming-Lung Yu3,4, Jun Hayashi25, Mindie H Nguyen26. 1. Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. 2. Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan. 3. Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. 4. Hepatitis Research Center, College of Medicine and Cohort Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan. 5. Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan. 6. Department of Gastroenterology, Hanyang University, Seoul, South Korea. 7. Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Cancer Hospital, Kaohsiung, Taiwan. 8. Department of Hepatology, Osaka City University Graduate School of Medicine, Osaka, Japan. 9. Liver Center, Saga University Hospital, Saga, Japan. 10. Division of Metabolism and Endocrinology, Saga University Faculty of Medicine, Saga, Japan. 11. Department of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong. 12. Department of Gastroenterology, Good Gang-An Hospital, Busan, Korea. 13. Department of Gastroenterology, Yamagata University Faculty of Medicine, Yamagata, Japan. 14. Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, South Korea. 15. Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University College of Medicine, Seoul, South Korea. 16. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong. 17. State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, Hong Kong. 18. Department of Gastroenterology, Kyushu Medical Center, National Hospital Organization, Fukuoka, Japan. 19. Department of Internal Medicine, Haradoi Hospital, Fukuoka, Japan. 20. Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, South Korea. 21. Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea. 22. Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, 780 Welch Road, Palo Alto, CA, 94304, USA. 23. Division of Gastroenterology and Hepatology, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA. 24. State Key Laboratory of Liver Research, The University of Hong Kong, Pok Fu Lam, Hong Kong. 25. Kyushu General Internal Medicine, Haradoi Hospital, Fukuoka, Japan. 26. Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, 780 Welch Road, Palo Alto, CA, 94304, USA. mindiehn@stanford.edu.
Abstract
BACKGROUND: Despite HCV cure, patients remain at risk for HCC, but risk factor data for HCC following SVR are limited for Asian patients. METHODS: To address this gap, we analyzed 5814 patients (5646 SVR, 168 non-SVR) from the Real-World Evidence from the Asia Liver Consortium for HCV (REAL-C) who did not have HCC or a history of HCC at baseline (pre-DAA treatment) and did not develop HCC within 6 months of baseline. To assess the effect of SVR on HCC incidence, we used 1:4 propensity score matching [(PSM), age, sex, baseline cirrhosis, and baseline AFP] to balance the SVR and non-SVR groups. RESULTS: In the PSM cohort (160 non-SVR and 612 SVR), the HCC incidence rate per 100 person years was higher in the non-SVR compared to the SVR group (5.26 vs. 1.94, p < 0.001). Achieving SVR was independently associated with decreased HCC risk (adjusted HR [aHR]: 0.41, p = 0.002). Next, we stratified the SVR cohort of 5646 patients to cirrhotic and noncirrhotic subgroups. Among cirrhotic SVR patients, aged ≥ 60, having an albumin bilirubin grade (ALBI) of 2 or 3 (aHR: 2.5, p < 0.001), and baseline AFP ≥ 10 ng/mL (aHR: 1.6, p = 0.001) were associated with higher HCC risk, while among the non-cirrhotic SVR group, only baseline AFP ≥ 10 ng/mL was significant (aHR: 4.26, p = 0.005). CONCLUSIONS: Achieving SVR decreases HCC risk; however, among East Asians, patients with elevated pretreatment AFP remained at risk. Pretreatment AFP, an easily obtained serum marker, may provide both prognostic and surveillance value for HCC in East Asian patients who obtained SVR.
BACKGROUND: Despite HCV cure, patients remain at risk for HCC, but risk factor data for HCC following SVR are limited for Asian patients. METHODS: To address this gap, we analyzed 5814 patients (5646 SVR, 168 non-SVR) from the Real-World Evidence from the Asia Liver Consortium for HCV (REAL-C) who did not have HCC or a history of HCC at baseline (pre-DAA treatment) and did not develop HCC within 6 months of baseline. To assess the effect of SVR on HCC incidence, we used 1:4 propensity score matching [(PSM), age, sex, baseline cirrhosis, and baseline AFP] to balance the SVR and non-SVR groups. RESULTS: In the PSM cohort (160 non-SVR and 612 SVR), the HCC incidence rate per 100 person years was higher in the non-SVR compared to the SVR group (5.26 vs. 1.94, p < 0.001). Achieving SVR was independently associated with decreased HCC risk (adjusted HR [aHR]: 0.41, p = 0.002). Next, we stratified the SVR cohort of 5646 patients to cirrhotic and noncirrhotic subgroups. Among cirrhotic SVR patients, aged ≥ 60, having an albumin bilirubin grade (ALBI) of 2 or 3 (aHR: 2.5, p < 0.001), and baseline AFP ≥ 10 ng/mL (aHR: 1.6, p = 0.001) were associated with higher HCC risk, while among the non-cirrhotic SVR group, only baseline AFP ≥ 10 ng/mL was significant (aHR: 4.26, p = 0.005). CONCLUSIONS: Achieving SVR decreases HCC risk; however, among East Asians, patients with elevated pretreatment AFP remained at risk. Pretreatment AFP, an easily obtained serum marker, may provide both prognostic and surveillance value for HCC in East Asian patients who obtained SVR.
Authors: Antonio Saviano; François Habersetzer; Joachim Lupberger; Pauline Simo-Noumbissie; Catherine Schuster; Michel Doffoël; Catherine Schmidt-Mutter; Thomas F Baumert Journal: Clin Transl Gastroenterol Date: 2022-06-01 Impact factor: 4.396
Authors: Gian Paolo Caviglia; Giulia Troshina; Umberto Santaniello; Giulia Rosati; Francesco Bombaci; Giovanni Birolo; Aurora Nicolosi; Giorgio Maria Saracco; Alessia Ciancio Journal: Cancers (Basel) Date: 2022-02-06 Impact factor: 6.639