학술논문

Prediction of recurrence following hepatectomy in patients with hepatitis C virus infection-related hepatocellular carcinoma who achieved a sustained virological response.
Document Type
Article
Source
Hepatology Research. Oct2017, Vol. 47 Issue 11, p1186-1195. 10p.
Subject
*HEPATITIS C virus
*LIVER cancer
*HEPATECTOMY
*ASPARTATE aminotransferase
*HEPATOPANCREATODUODENECTOMY
*LIVER surgery
*SURGICAL excision
Language
ISSN
1386-6346
Abstract
Aim The risk of hepatitis C virus infection -related hepatocellular carcinoma (HCC) is lower, with a better prognosis, in patients who achieve a sustained virological response (SVR) than in those who do not. We aimed to identify risk factors of post-hepatectomy HCC recurrence in patients who achieved a SVR. Methods This retrospective study included 349 HCC patients who underwent an initial radical hepatectomy at our institution between January 2005 and December 2014. Sixty-eight patients had achieved a SVR (the SVR group) and 281 patients had not (the non-SVR group). Clinical characteristics and long-term outcomes were compared between the two groups. Univariate and multivariate analyses identified variables associated with recurrence-free survival in the SVR group. Results Post-hepatectomy overall and recurrence-free survival rates were significantly higher in the SVR group than the non-SVR group ( P < 0.01 and <0.05, respectively). Univariate analysis of post-hepatectomy recurrence-free survival in the SVR group revealed multiple significant factors: aspartate aminotransferase, 25 IU/L or more ( P = 0.01); indocyanine green retention rate at 15 min, 20.0% or less ( P < 0.05); hepatic vascular invasion ( P < 0.05); and an interval of months or less between achieving a SVR and hepatectomy ( P < 0.01). Multivariate analysis confirmed an interval of 30 months or less between achieving a SVR and hepatectomy as an independent prognostic factor of recurrence-free survival (hazard ratio, 2.30; 95.0% confidence interval, 1.04-5.13; P < 0.05). Conclusion The interval between achieving a SVR and hepatectomy is an important predictor of recurrence in hepatitis C virus infection-related HCC patients who achieved a SVR. [ABSTRACT FROM AUTHOR]