Long-Term Outcomes of Hepatitis-C-Infected Patients Achieving a Sustained Virological Response and Undergoing Radical Treatment for Hepatocellular Carcinoma

Oncology. 2016;90(3):167-75. doi: 10.1159/000443891. Epub 2016 Feb 23.

Abstract

Background and aims: A sustained virological response (SVR) decreases the incidence of hepatocellular carcinoma (HCC) in patients with hepatitis C. We investigated the long-term outcomes of patients who developed HCC after achieving SVR with interferon therapy.

Patients: Of 75 patients who developed HCC after SVR, 40 patients underwent radical therapies (SVR group). From 436 patients undergoing surgical resection for hepatitis C virus-positive HCC, 80 patients were randomly chosen as a control cohort, after adjusting for age, gender, and extent of hepatic fibrosis (non-SVR group). Patients were observed for a median of 5.08 years.

Results: HCC recurrence was found in 16 SVR patients and in 66 non-SVR patients. The respective HCC recurrence rates of SVR and non-SVR patients were 23 and 56% at 3 years, 42 and 77% at 5 years, and 53 and 90% at 10 years (p = 0.001). The respective overall survival rates in the SVR and non-SVR groups were 93 and 68% at 5 years, 88 and 34% at 10 years, and 53 and 21% at 15 years (p = 0.001).

Conclusion: Although SVR patients had a significantly lower HCC recurrence rate than the non-SVR patients, the cumulative recurrence rate of SVR patients increased to 86% at 15 years.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antiviral Agents / therapeutic use*
  • Carcinoma, Hepatocellular / diagnosis
  • Carcinoma, Hepatocellular / surgery*
  • Carcinoma, Hepatocellular / therapy
  • Carcinoma, Hepatocellular / virology
  • Female
  • Hepatectomy*
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / drug therapy*
  • Humans
  • Incidence
  • Interferon-alpha / therapeutic use
  • Kaplan-Meier Estimate
  • Liver Neoplasms / diagnosis
  • Liver Neoplasms / surgery*
  • Liver Neoplasms / therapy
  • Liver Neoplasms / virology
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnosis
  • Ribavirin / therapeutic use
  • Viral Load / drug effects

Substances

  • Antiviral Agents
  • Interferon-alpha
  • Ribavirin