Viral elimination is essential for improving surgical outcomes of hepatitis C virus‐related hepatocellular carcinoma: Multicenter retrospective analysis. Issue 6 (23rd July 2020)

• Record Type: Journal Article
• Authors: Nakajima, Masao; Kobayashi, Shogo; Wada, Hiroshi; Tomokuni, Akira; Takahashi, Hidenori; Noda, Takehiro; Matsui, Hiroto; Matsukuma, Satoshi; Kanekiyo, Shinsuke; Shindo, Yoshitaro; Tokumitsu, Yukio; Nakagami, Yuki; Suzuki, Nobuaki; Takeda, Shigeru; Tanabe, Masahiro; Ito, Katsuyoshi; Hoshii, Yoshinobu; Eguchi, Hidetoshi; Nagano, Hiroaki
• Is Part Of: Annals of gastroenterological surgery. Volume 4:Issue 6(2020)
• Page Start: 710
• Page End: 720
• Publication Date: 2020-07-23
• Subjects: hepatectomy -- hepatitis C virus -- hepatocellular carcinoma -- regression of liver fibrosis -- sustained virologic response; Digestive organs -- Surgery -- Periodicals; 617.43
• DOI: 10.1002/ags3.12377
• Languages: English
• ISSNs: 2475-0328

Abstract

Abstract: Aim: The impact of sustained virologic response (SVR) on surgical outcomes for patients with hepatitis C virus (HCV)‐related hepatocellular carcinoma (HCC) remains controversial. This study aimed to evaluate the influence of SVR on long‐term surgical outcomes after hepatectomy. Methods: This multicenter study included 504 patients who underwent curative resection for HCV‐related HCC. Patients with a history of HCC treatment, HBV infection, poor liver function, and tumor with major vascular invasion were excluded. Long‐term surgical outcomes (overall survival [OS] and recurrence‐free survival [RFS]) among patients who achieved SVR before hepatectomy (Pre‐SVR group: 58 patients), after hepatectomy (Post‐SVR group: 54 patients), and without SVR (Non‐SVR group: 186 patients) were compared after adjusting for 13 confounding factors. Using the surgically resected specimens, comparison of the pathological changes in liver fibrosis between the first and second hepatectomy were analyzed. Results: Patients with SVR were younger, had better liver function, and less liver fibrosis compared to patients without SVR. Propensity score‐matched OS and RFS were significantly better in Pre‐SVR group than Non‐SVR group ( P = .029 and P = .009, respectively). Inverse probability‐weighted OS and RFS were also significantly better in the Post‐SVR group ( P = .001 and P = .021, respectively) than in the Non‐SVR group. Histopathological evaluation revealed that only the patients with SVR had regression of liver fibrosis ( P < .05). Conclusion: Achievement of SVR before or after hepatectomy is essential for improving long‐term surgical outcomes in patients with HCV‐related HCC. Abstract : Although the achievement of sustained virologic response (SVR) is essential for improving survival in patients with hepatitis C virus (HCV) infection, its importance on surgical outcomes for HCV‐related hepatocellular carcinoma (HCC) is still controversial. In this multicenter study, we demonstrated the importance of achieving SVR before or after hepatectomy for improving long‐term surgical outcomes. These results can encourage patients with HCV‐related HCC to undergo antiviral therapy regardless of the timing.