Effect of achieving sustained virological response before hepatitis C virus-related hepatocellular carcinoma occurrence on survival and recurrence after curative surgical microwave ablation

Hepatol Int. 2018 Mar;12(2):149-157. doi: 10.1007/s12072-018-9851-4. Epub 2018 Feb 27.

Abstract

Background and aim: The effects of achieving sustained virological response (SVR) on recurrence and survival after curative treatment in patients with hepatitis virus C (HCV)-related hepatocellular carcinoma (HCC) is unclear. This study examined the influence of SVR achievement by interferon therapy before HCC occurrence on recurrence and survival.

Methods: This retrospective study included 518 patients who underwent surgical microwave ablation for initial HCV-related HCC between January 2001 and December 2015. Thirty-four patients had achieved SVR (SVR group) and 484 patients had not (control group). Clinical characteristics and long-term outcomes were compared between the two groups.

Results: Overall survival rates at 5 and 10 years after curative ablation were 95.8 and 80.4% in the SVR group, and 50.7 and 23.4% in the control, respectively (p < 0.0001). Recurrence-free survival rates at 5 and 10 years were 68.7 and 26.4% in the SVR group, and 24.5 and 7.8% in the control group, respectively (p < 0.0001). Multivariate analyses revealed that achieving SVR as an independent prognostic factor for both overall and recurrence-free survival. In the SVR group, the 5-year recurrence-free survival rates for patients with an interval of 5 years or fewer (n = 24) vs. more than 5 years (n = 10) between achieving SVR and curative ablation were 58.7 and 88.9%, respectively (p = 0.03).

Conclusions: Achieving SVR before HCC occurrence allowed a favorable clinical outcome after curative ablation in HCV-related HCC patients. Patients with HCC that occurred more than 5 years after achieving SVR had longer recurrence-free survival.

Keywords: Hepatitis C; Hepatocellular carcinoma; Interferon; Microwave ablation; Sustained virological response.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antiviral Agents / therapeutic use*
  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / surgery*
  • Carcinoma, Hepatocellular / virology
  • Case-Control Studies
  • Catheter Ablation / methods*
  • Disease-Free Survival
  • Female
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / mortality
  • Humans
  • Liver Neoplasms / mortality
  • Liver Neoplasms / surgery*
  • Liver Neoplasms / virology
  • Male
  • Microwaves / therapeutic use
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Recurrence
  • Sustained Virologic Response
  • Treatment Outcome

Substances

  • Antiviral Agents