Open AccessViral elimination is essential for improving surgical outcomes of hepatitis C virus‐related hepatocellular carcinoma: Multicenter retrospective analysis
Author(s) -
Nakajima Masao,
Kobayashi Shogo,
Wada Hiroshi,
Tomokuni Akira,
Takahashi Hidenori,
Noda Takehiro,
Matsui Hiroto,
Matsukuma Satoshi,
Kanekiyo Shinsuke,
Shindo Yoshitaro,
Tokumitsu Yukio,
Nakagami Yuki,
Suzuki Nobuaki,
Takeda Shigeru,
Tanabe Masahiro,
Ito Katsuyoshi,
Hoshii Yoshinobu,
Eguchi Hidetoshi,
Nagano Hiroaki
Publication year - 2020
Publication title -
annals of gastroenterological surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.308
H-Index - 15
ISSN - 2475-0328
DOI - 10.1002/ags3.12377
Subject(s) - medicine , hepatocellular carcinoma , hepatectomy , gastroenterology , liver function , hepatitis c virus , retrospective cohort study , hepatitis b virus , confounding , propensity score matching , surgery , virus , resection , immunology
Aim The impact of sustained virologic response (SVR) on surgical outcomes for patients with hepatitis C virus (HCV)‐related hepatocellular carcinoma (HCC) remains controversial. This study aimed to evaluate the influence of SVR on long‐term surgical outcomes after hepatectomy. Methods This multicenter study included 504 patients who underwent curative resection for HCV‐related HCC. Patients with a history of HCC treatment, HBV infection, poor liver function, and tumor with major vascular invasion were excluded. Long‐term surgical outcomes (overall survival [OS] and recurrence‐free survival [RFS]) among patients who achieved SVR before hepatectomy (Pre‐SVR group: 58 patients), after hepatectomy (Post‐SVR group: 54 patients), and without SVR (Non‐SVR group: 186 patients) were compared after adjusting for 13 confounding factors. Using the surgically resected specimens, comparison of the pathological changes in liver fibrosis between the first and second hepatectomy were analyzed. Results Patients with SVR were younger, had better liver function, and less liver fibrosis compared to patients without SVR. Propensity score‐matched OS and RFS were significantly better in Pre‐SVR group than Non‐SVR group ( P = .029 and P = .009, respectively). Inverse probability‐weighted OS and RFS were also significantly better in the Post‐SVR group ( P = .001 and P = .021, respectively) than in the Non‐SVR group. Histopathological evaluation revealed that only the patients with SVR had regression of liver fibrosis ( P < .05). Conclusion Achievement of SVR before or after hepatectomy is essential for improving long‐term surgical outcomes in patients with HCV‐related HCC.