BACKGROUND: The effects of direct-acting antivirals (DAAs) on survival and recurrence rates after curative hepatocellular carcinoma (HCC) treatment in patients with hepatitis C virus (HCV) infection remain controversial. METHODS: This retrospective, multicenter study involved Child-Pugh class A patients within the Milan criteria who had a first diagnosis of HCC and survived 6 months or longer after undergoing hepatectomy or radiofrequency ablation (RFA). The DAA-treated group (DAA group) included 56 patients, and the DAA-untreated group (untreated group) included 261 patients. The study was conducted using the propensity score-matched (1:2) DAA group and untreated group, 56 and 112 patients, respectively. RESULTS: The survival rate at 48 months in the DAA group and the untreated group was 91.0% and 68.7%, respectively, showing significantly better survival in the DAA group (HR: 0.33; 95% CI 0.13-0.84; p = 0.021). The recurrence rate at 48 months was 36.7% and 66.7%, respectively, showing a significantly lower recurrence rate in the DAA group (HR, 0.46; 95% CI 0.27-0.77; p = 0.003). The median albumin-bilirubin (ALBI) score at 3 years post-HCC treatment was - 2.84 in the DAA group and - 2.34 in the untreated group. The ALBI score showed a significant improvement from baseline to 3 years post-HCC treatment (p = 0.001), whereas that in the untreated group showed a significant decline (p = 0.040). CONCLUSIONS: DAAs after HCC treatment prevents deterioration of hepatic functional reserve and significantly improves both recurrence and survival rates.
BACKGROUND: The effects of direct-acting antivirals (DAAs) on survival and recurrence rates after curative hepatocellular carcinoma (HCC) treatment in patients with hepatitis C virus (HCV) infection remain controversial. METHODS: This retrospective, multicenter study involved Child-Pugh class A patients within the Milan criteria who had a first diagnosis of HCC and survived 6 months or longer after undergoing hepatectomy or radiofrequency ablation (RFA). The DAA-treated group (DAA group) included 56 patients, and the DAA-untreated group (untreated group) included 261 patients. The study was conducted using the propensity score-matched (1:2) DAA group and untreated group, 56 and 112 patients, respectively. RESULTS: The survival rate at 48 months in the DAA group and the untreated group was 91.0% and 68.7%, respectively, showing significantly better survival in the DAA group (HR: 0.33; 95% CI 0.13-0.84; p = 0.021). The recurrence rate at 48 months was 36.7% and 66.7%, respectively, showing a significantly lower recurrence rate in the DAA group (HR, 0.46; 95% CI 0.27-0.77; p = 0.003). The median albumin-bilirubin (ALBI) score at 3 years post-HCC treatment was - 2.84 in the DAA group and - 2.34 in the untreated group. The ALBI score showed a significant improvement from baseline to 3 years post-HCC treatment (p = 0.001), whereas that in the untreated group showed a significant decline (p = 0.040). CONCLUSIONS: DAAs after HCC treatment prevents deterioration of hepatic functional reserve and significantly improves both recurrence and survival rates.
Authors: Charing Ching-Ning Chong; Anthony Wing-Hung Chan; John Wong; Cheuk-Man Chu; Stephen Lam Chan; Kit-Fai Lee; Simon Chun-Ho Yu; Ka-Fai To; Philip Johnson; Paul Bo-San Lai Journal: Surgeon Date: 2017-08-12 Impact factor: 2.392
Authors: Charing C N Chong; Kit-Fai Lee; Cheuk-Man Chu; Anthony W H Chan; John Wong; Stephen L Chan; Hon-Ting Lok; Andrew K Y Fung; Anthony K W Fong; Yue S Cheung; Simon C H Yu; Philip Johnson; Paul B S Lai Journal: HPB (Oxford) Date: 2018-01-17 Impact factor: 3.647
Authors: Michael Charlton; Gregory T Everson; Steven L Flamm; Princy Kumar; Charles Landis; Robert S Brown; Michael W Fried; Norah A Terrault; Jacqueline G O'Leary; Hugo E Vargas; Alexander Kuo; Eugene Schiff; Mark S Sulkowski; Richard Gilroy; Kymberly D Watt; Kimberly Brown; Paul Kwo; Surakit Pungpapong; Kevin M Korenblat; Andrew J Muir; Lewis Teperman; Robert J Fontana; Jill Denning; Sarah Arterburn; Hadas Dvory-Sobol; Theo Brandt-Sarif; Phillip S Pang; John G McHutchison; K Rajender Reddy; Nezam Afdhal Journal: Gastroenterology Date: 2015-05-15 Impact factor: 22.682