Surgical Outcomes in Hepatitis C Virus-Related Hepatocellular Carcinoma: Special Reference to Sustained Virological Responses to Interferon Therapy

Long-term surgical outcomes after hepatic resection for hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) in patients who achieved a sustained virological response (SVR) to interferon (IFN) therapy remain inconclusive. Clinical records of 277 patients who underwent hepatic resection for...

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Bibliographic Details
Published in:The American surgeon 2017-11, Vol.83 (11), p.1246-1255
Main Authors: Tanaka, Shogo, Tamori, Akihiro, Takemura, Shigekazu, Hamano, Genya, Ito, Tokuji, Kawada, Norifumi, Kubo, Shoji
Format: Article
Language:English
Subjects:
Hepatitis
Hepatitis C
Hepatocellular carcinoma
Interferon
Liver cancer
Multivariate analysis
Patients
Surgery
Surgical outcomes
Survival
Therapy
Viruses
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Summary:Long-term surgical outcomes after hepatic resection for hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) in patients who achieved a sustained virological response (SVR) to interferon (IFN) therapy remain inconclusive. Clinical records of 277 patients who underwent hepatic resection for HCV-related early stage HCC (met the Milan criteria) between 1993 and 2012 were retrospectively reviewed. Thirty-seven patients achieved the SVR during HCC detection (pre-SVR group), whereas 23 achieved SVR using adjuvant interferon therapy after hepatic resection (post-SVR group). The control group included remaining 217 patients. We investigated the SVR effects on surgical outcomes. Disease-free survival (DFS) rates at 5/10/15 years after hepatic resection were significantly greater in the pre and post-SVR groups than in the control group (46/30/30per cent and 61/36/27 per cent vs 23/7/7 per cent, respectively; P < 0.001). Overall survival (OS) rates at 10/15 years after hepatic resection were better in the pre- and post-SVR groups than in the control group (68/68 percent and 78/78 per cent vs 13/11 per cent, respectively; P < 0.001). On multivariate analysis, pre- and post-SVR were independent factors for no recurrence (pre-SVR: hazard ratio (HR), 0.48, P = 0.002; post-SVR: HR, 0.41, P = 0.001) and improved survival (pre-SVR: HR, 0.36, P = 0.002; post-SVR: HR, 0.122, P < 0.001). Achievement of SVR in patients with HCV-related HCC was associated with long-term disease-free survival and OS after hepatic resection.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313481708301127