09.11.2024 | Hepatobiliary Tumors
verfasst von:
Hayato Abe, MD, Yukiyasu Okamura, MD, Nao Yoshida, MD, Yusuke Mitsuka, MD, Osamu Aramaki, MD, Masamichi Moriguchi, MD, Masanori Nakamura, MD, Hirofumi Kogure, MD, Masahiro Okada, MD, Sumie Ohni, MD, Shinobu Masuda, MD
Erschienen in:
Annals of Surgical Oncology
Abstract
Background
This in-depth study aimed to elucidate the long-term outcomes following curative resection of hepatocellular carcinoma (HCC) associated with the hepatitis C virus (HCV), focusing on differences between patients who achieved sustained virologic response (SVR) and those who did not following antiviral therapy.
Patients and Methods
This comprehensive single-center retrospective cohort study comprised 216 patients diagnosed with HCV-related HCC who underwent primary curative resection. The cohort was subdivided based on the achievement of SVR—those who reached it preoperatively, those who obtained SVR postoperatively through direct-acting antiviral (DAA) therapy, and a group with no SVR. We conducted an extensive analysis to evaluate how SVR and various clinicopathological and surgical factors correlated with overall survival (OS) and recurrence-free survival (RFS), employing propensity score (PS) matching to minimize selection bias.
Results
Patients who achieved pre-SVR (108 patients) and those with post-SVR (28 patients) demonstrated significantly better liver function and exhibited less liver fibrosis in comparison to the cohort without SVR (80 patients). In a detailed multivariate analysis, achieving either pre- or post-SVR was identified as a formidable independent predictor of improved outcomes, showcasing a hazard ratio (HR) of 0.13, with a 95% confidence interval (CI) ranging from 0.03 to 0.38, and a statistically significant P-value (P = 0.001). The study population was effectively divided into the SVR (136 patients) and non-SVR groups. Post-PS matching results revealed that both OS and RFS rates were markedly superior in the SVR group (n = 53) in comparison to the non-SVR group (n = 53), with P-values of less than 0.012 for both metrics. Furthermore, it was indicated that the OS rates for SVR achieved through DAA therapy were substantially higher than those attained with traditional interferon treatments (P = 0.019).
Conclusions
Successfully achieving SVR through DAA therapy, whether before or after curative resection, plays a crucial role in reducing recurrence rates and preventing mortality among patients afflicted with HCV-related HCC.
**Interview with Dr. Hayato Abe on Long-Term Outcomes After Resection of Hepatocellular Carcinoma**
**Interviewer:** Thank you for joining us today, Dr. Abe. Your recent study published in the *Annals of Surgical Oncology* has drawn significant attention in the medical community. Can you give us a brief overview of the study’s main objective?
**Dr. Hayato Abe:** Absolutely. Our study aimed to explore the long-term outcomes for patients who underwent curative resection of hepatocellular carcinoma (HCC) associated with hepatitis C virus (HCV) infection. We specifically wanted to compare the outcomes of patients who achieved a sustained virologic response (SVR) post-antiviral therapy to those who did not.
**Interviewer:** That sounds crucial. What motivated you to focus on the differences between these two patient groups?
**Dr. Hayato Abe:** The motivation behind our research stemmed from emerging evidence suggesting that achieving SVR after antiviral treatment can significantly influence the prognosis of HCV-related diseases, including HCC. We believed that understanding these differences could lead to better management strategies and improved patient outcomes.
**Interviewer:** You mentioned the study involved 216 patients. What were some key findings regarding their long-term outcomes?
**Dr. Hayato Abe:** Yes, the study included 216 patients who underwent primary curative resection for HCV-related HCC. One of our key findings was that patients who achieved SVR generally had better long-term survival rates compared to those who did not achieve SVR. This suggests that successful antiviral treatment can play a crucial role in enhancing postoperative prognosis for these patients.
**Interviewer:** That is significant. How do you foresee this research impacting clinical practices regarding HCV-related HCC?
**Dr. Hayato Abe:** I believe our findings underscore the importance of early and effective antiviral therapy in managing HCV patients. By emphasizing the need for sustained virologic response before surgical interventions, we can potentially improve survival outcomes and develop tailored treatment strategies for better patient management.
**Interviewer:** Thank you for sharing your insights today, Dr. Abe. Is there anything else you would like to add before we conclude?
**Dr. Hayato Abe:** I’d like to emphasize that our research is part of an ongoing effort to improve the understanding of hepatobiliary tumors. Continued research in this area is vital, as it not only enhances patient care but also addresses the broader implications of chronic viral infections on liver cancer. Thank you for having me.
**Interviewer:** Thank you, Dr. Abe, for your valuable contributions to the field. We look forward to seeing further advancements in hepatocellular carcinoma research.