BACKGROUND Hepatocellular carcinoma(HCC)in hepatitis C virus(HCV)-infected patients has a high risk of recurrence.Although eradication of HCV is expected to reduce this risk,the risk in patients with a history of HCC ...BACKGROUND Hepatocellular carcinoma(HCC)in hepatitis C virus(HCV)-infected patients has a high risk of recurrence.Although eradication of HCV is expected to reduce this risk,the risk in patients with a history of HCC may be high after treatment with direct-acting antivirals(DAAs).AIM To determine the risk factors for HCC recurrence in patients with HCV and a history of HCC.METHODS The risk of HCC recurrence in patients with a history of HCC and/or of HCC occurrence in patients without a history of HCC after DAA therapy was retrospectively analyzed in 311 HCV patients treated at our institution and several neighboring hospitals.The frequency and predictors of HCC recurrence/occurrence after DAA treatment were included in these analyses.The clinical course of HCC before and after DAA treatment was also evaluated.RESULTS HCV patients with a history of HCC were older and had greater progression of liver fibrosis and diabetes than patients without a history of HCC.Median recurrence-free survival(RFS)was 1092 d in patients with a history of HCC,and post-DAA HCC recurrence/occurrence was observed in 29 patients(53.7%)with and 5(1.9%)without a history of HCC over 6 years(P<0.001).RFS in patients with a history of HCC did not differ significantly before and after DAA treatment.The frequency of HCC recurrence/occurrence in patients with a history of HCC was lower after than before DAA treatment.Multivariate analysis showed that the incidence rate of HCC recurrence/occurrence before DAA treatment was the only independent predictor of HCC recurrence/occurrence after DAA treatment.Liver function was well preserved and clinical course was good in patients with HCC recurrence/occurrence after DAA therapy.CONCLUSION DAA therapy in patients infected with HCV is also effective in patients with a history of HCC.Curative treatment for HCC is desirable before DAA therapy.The frequency of HCC recurrence/occurrence before DAA therapy was associated with a significantly increased risk of HCC recurrence after DAA therapy.Careful observation after DAA therapy is required in patients with a history of HCC.展开更多
文摘BACKGROUND Hepatocellular carcinoma(HCC)in hepatitis C virus(HCV)-infected patients has a high risk of recurrence.Although eradication of HCV is expected to reduce this risk,the risk in patients with a history of HCC may be high after treatment with direct-acting antivirals(DAAs).AIM To determine the risk factors for HCC recurrence in patients with HCV and a history of HCC.METHODS The risk of HCC recurrence in patients with a history of HCC and/or of HCC occurrence in patients without a history of HCC after DAA therapy was retrospectively analyzed in 311 HCV patients treated at our institution and several neighboring hospitals.The frequency and predictors of HCC recurrence/occurrence after DAA treatment were included in these analyses.The clinical course of HCC before and after DAA treatment was also evaluated.RESULTS HCV patients with a history of HCC were older and had greater progression of liver fibrosis and diabetes than patients without a history of HCC.Median recurrence-free survival(RFS)was 1092 d in patients with a history of HCC,and post-DAA HCC recurrence/occurrence was observed in 29 patients(53.7%)with and 5(1.9%)without a history of HCC over 6 years(P<0.001).RFS in patients with a history of HCC did not differ significantly before and after DAA treatment.The frequency of HCC recurrence/occurrence in patients with a history of HCC was lower after than before DAA treatment.Multivariate analysis showed that the incidence rate of HCC recurrence/occurrence before DAA treatment was the only independent predictor of HCC recurrence/occurrence after DAA treatment.Liver function was well preserved and clinical course was good in patients with HCC recurrence/occurrence after DAA therapy.CONCLUSION DAA therapy in patients infected with HCV is also effective in patients with a history of HCC.Curative treatment for HCC is desirable before DAA therapy.The frequency of HCC recurrence/occurrence before DAA therapy was associated with a significantly increased risk of HCC recurrence after DAA therapy.Careful observation after DAA therapy is required in patients with a history of HCC.
