ABSTRACT

Background

There are many contradictory studies that dealt with hepatocellular carcinoma (HCC) recurrence rate of well ablated hepatitis C virus (HCV) related HCC. We aim to assess the recurrence rate of previously ablated HCC in patients who received direct acting antiviral (DAA) for their HCV.

Research design and methods

This is a retrospective data analysis of 523 HCV patients who have a history of successfully ablated HCC and eligible for HCV treatment. Retrieval was done to demographic/clinical data, HCV pretreatment investigations, HCV treatment outcome. Follow up for survival and HCC recurrence was done every 3 months using abdominal ultrasound and alfa-fetoprotein.

Results

Mean age was 53.83 years. Sofosbuvir/daclatasvir/ribavirin was the most used regimen (35.4%) with 438 patients (83.7%) achieved sustained virologic response (SVR). The median duration for surveillance was 159 weeks. Hundred and five patients developed recurrent HCC, with a crude recurrence rate of 20.1%. There was no difference between HCV responders and non-responders in crude recurrence rate (p = 0.94) but HCC developed earlier in non-responders (p = <0.01).

Conclusion

Recurrence of HCC remains a threat in HCV patients even after achieving an SVR. Implementation of long-term surveillance programs is highly recommended.

中文翻译：

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使用直接作用抗病毒药物成功治疗 HCV 对消融良好的肝细胞癌复发的影响

摘要

背景

有许多相互矛盾的研究涉及消融良好的丙型肝炎病毒 (HCV) 相关 HCC 的肝细胞癌 (HCC) 复发率。我们的目标是评估接受直接抗病毒药物 (DAA) 治疗 HCV 的患者先前消融的 HCC 的复发率。

研究设计与方法

这是对 523 名 HCV 患者的回顾性数据分析，这些患者有成功消融 HCC 的病史并有资格接受 HCV 治疗。对人口统计/临床数据、HCV 治疗前调查、HCV 治疗结果进行检索。每 3 个月使用腹部超声和甲胎蛋白对生存和 HCC 复发进行随访。

结果

平均年龄为 53.83 岁。Sofosbuvir/daclatasvir/ribavirin 是最常用的方案（35.4%），438 名患者（83.7%）实现了持续病毒学应答（SVR）。监测的中位持续时间为 159 周。105名患者发生复发性HCC，粗复发率为20.1%。HCV 应答者和无应答者的粗复发率无差异（p = 0.94），但无应答者较早发生 HCC（p = <0.01）。

结论

即使在达到 SVR 后，HCC 的复发仍然是 HCV 患者的威胁。强烈建议实施长期监测计划。