A meta‐analysis of single HCV‐untreated arm of studies evaluating outcomes after curative treatments of HCV‐related hepatocellular carcinoma. (1st February 2017)

• Record Type: Journal Article
• Authors: Cabibbo, Giuseppe; Petta, Salvatore; Barbàra, Marco; Missale, Gabriele; Virdone, Roberto; Caturelli, Eugenio; Piscaglia, Fabio; Morisco, Filomena; Colecchia, Antonio; Farinati, Fabio; Giannini, Edoardo; Trevisani, Franco; Craxì, Antonio; Colombo, Massimo; Cammà, Calogero
• Other Names: Bucci Laura investigator.; Zoli Marco investigator.; Garuti Francesca investigator.; Lenzi Barbara investigator.; Biselli Maurizio investigator.; Caraceni Paolo investigator.; Cucchetti Alessandro investigator.; Gramenzi Annagiulia investigator.; Granito Alessandro investigator.; Magalotti Donatella investigator.; Serra Carla investigator.; Negrini Giulia investigator.; Napoli Lucia investigator.; Salvatore Veronica investigator.; Benevento Francesca investigator.; Benvegnù Luisa investigator.; Gazzola Alessia investigator.; Murer Francesca investigator.; Pozzan Caterina investigator.; Vanin Veronica investigator.; Moscatelli Alessandro investigator.; Pellegatta Gaia investigator.; Picciotto Antonino investigator.; Savarino Vincenzo investigator.; Ciccarese Francesca investigator.; Del Poggio Paolo investigator.; Olmi Stefano investigator.; de Matthaeis Nicoletta investigator.; Balsamo Mariella Di Marco Claudia investigator.; Vavassori Elena investigator.; Roselli Paola investigator.; Dell'Isola Serena investigator.; Ialungo Anna Maria investigator.; Rastrelli Elena investigator.; Attardo Simona investigator.; Rossi Margherita investigator.; Costantino Andrea investigator.; Affronti Andrea investigator.; Affronti Marco investigator.; Mascari Marta investigator.; Felder Martina investigator.; Mega Andrea investigator.; Gasbarrini Antonio investigator.; Pompili Maurizio investigator.; Rinninella Emanuele investigator.; Sacco Rodolfo investigator.; Mismas Valeria investigator.; Foschi Francesco Giuseppe investigator.; Dall'Aglio Anna Chiara investigator.; Feletti Valentina investigator.; Lanzi Arianna investigator.; Cappa Federica Mirici investigator.; Neri Elga investigator.; Stefanini Giuseppe Francesco investigator.; Tamberi Stefano investigator.; Olivani Andrea investigator.; Biasini Elisabetta investigator.; Nardone Gerardo investigator.; Guarino Maria investigator.; Svegliati‐Baroni Gialuca investigator.; Ortolani Alessio investigator.; Masotto Alberto investigator.; Marchetti Fabiana investigator.; Valerio Matteo investigator.; Marra Fabio investigator.; Aburas Sami investigator.; Inghilesi Andrea L investigator.; Cappelli Alberta investigator.; Golfieri Rita investigator.; Mosconi Cristina investigator.; Renzulli Matteo investigator.; Coccoli Piero investigator.; Zamparelli Marco Sanduzzi investigator.;
• Is Part Of: Liver international. Volume 37:Number 8(2017)
• Page Start: 1157
• Page End: 1166
• Publication Date: 2017-02-01
• Subjects: hepatocellular carcinoma -- prognosis -- recurrences -- survival; Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.13357
• Languages: English
• ISSNs: 1478-3223

Abstract

Abstract: Background & Aims: Determining risk for recurrence or survival after curative resection or ablation in patients with hepatitis C virus (HCV)‐related hepatocellular carcinoma (HCC) is important for stratifying patients according to expected outcomes in future studies of adjuvant therapy in the era of direct‐acting antivirals (DAAs). The aims of this meta‐analysis were to estimate the recurrence and survival probabilities of HCV‐related early HCC following complete response after potentially curative treatment and to identify predictors of recurrence and survival. Methods: Studies reporting time‐dependent outcomes (HCC recurrence or death) after potentially curative treatment of HCV‐related early HCC were identified in MEDLINE through May 2016. Data on patient populations and outcomes were extracted from each study by three independent observers and combined using a distribution‐free summary survival curve. Primary outcomes were actuarial probabilities of recurrence and survival. Results: Eleven studies met the inclusion criteria. Pooled estimates of actuarial recurrence rates were 7.4% at 6 months and 47.0% at 2 years. Pooled estimates of actuarial survival rates were 79.8% at 3 years and 58.6% at 5 years. Heterogeneity among studies was highly significant for all outcomes. By univariate meta‐regression analyses, lower serum albumin, randomized controlled trial study design and follow‐up were independently associated with higher recurrence risk, whereas tumour size and alpha‐foetoprotein levels were associated with higher mortality. Conclusions: This meta‐analysis showed that recurrence risk and survival are extremely variable in patients with successfully treated HCV‐related HCC, providing a useful benchmark for indirect comparisons of the benefits of DAAs and for a correct design of randomized controlled trials in the adjuvant setting.