Aim:The increased risk of hepatocellular carcinoma(HCC)recurrence in hepatitis C virus(HCV)-infected patients treated with direct-acting antivirals(DAAs)after curative treatment for HCC is controversial.The purpose of...Aim:The increased risk of hepatocellular carcinoma(HCC)recurrence in hepatitis C virus(HCV)-infected patients treated with direct-acting antivirals(DAAs)after curative treatment for HCC is controversial.The purpose of this study was to examine the risk of HCC recurrence after DAA therapy.Methods:We conducted a retrospective cohort study of 312 consecutive patients with HCV-related HCC who received DAA therapy in participating institutions between September 2014 and July 2016.All patients received curative ;hepatectomy or radio-frequency ablation.We calculated the annual incidence of HCC recurrence after DAA therapy and identified the risk factors for HCC recurrence using Cox regression models.Results:The median age was 74 years old,and a sustained virological response was achieved by 288 patients.The 3-year-overall survival rate was 95.4%in a median follow-up period of 855 days.HCC recurred in 135 patients.The 1-,2-and 3-year recurrence rates were 18.3%,38.8%and 55.4%,respectively.A multivariate analysis revealed that the following factors were associated with HCC recurrence:multiple tumors at the first HCC treatment[hazard ratio(HR)=2.21;95%CI:1.41-3.49],a history of multiple treatments for HCC(HR=1.97;95%CI:1.28-3.02),andα-fetoprotein(AFP-L3)≥10%at the initiation of DAA therapy(HR=4.74;95%CI:2.10-10.7).Conclusion:Among patients treated with DAAs after the curative treatment of HCC,multiple tumors at the first HCC treatment,multiple prior HCC treatments and a high AFP-L3 level before DAA therapy were associated with recurrence,and the rate of recurrence was comparable to that before the DAA era.展开更多
文摘Aim:The increased risk of hepatocellular carcinoma(HCC)recurrence in hepatitis C virus(HCV)-infected patients treated with direct-acting antivirals(DAAs)after curative treatment for HCC is controversial.The purpose of this study was to examine the risk of HCC recurrence after DAA therapy.Methods:We conducted a retrospective cohort study of 312 consecutive patients with HCV-related HCC who received DAA therapy in participating institutions between September 2014 and July 2016.All patients received curative ;hepatectomy or radio-frequency ablation.We calculated the annual incidence of HCC recurrence after DAA therapy and identified the risk factors for HCC recurrence using Cox regression models.Results:The median age was 74 years old,and a sustained virological response was achieved by 288 patients.The 3-year-overall survival rate was 95.4%in a median follow-up period of 855 days.HCC recurred in 135 patients.The 1-,2-and 3-year recurrence rates were 18.3%,38.8%and 55.4%,respectively.A multivariate analysis revealed that the following factors were associated with HCC recurrence:multiple tumors at the first HCC treatment[hazard ratio(HR)=2.21;95%CI:1.41-3.49],a history of multiple treatments for HCC(HR=1.97;95%CI:1.28-3.02),andα-fetoprotein(AFP-L3)≥10%at the initiation of DAA therapy(HR=4.74;95%CI:2.10-10.7).Conclusion:Among patients treated with DAAs after the curative treatment of HCC,multiple tumors at the first HCC treatment,multiple prior HCC treatments and a high AFP-L3 level before DAA therapy were associated with recurrence,and the rate of recurrence was comparable to that before the DAA era.
