Comparison of postoperative outcomes in cases achieving sustained virological response with direct-acting antiviral and interferon therapy.

J Hepatobiliary Pancreat Sci

Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.

Published: May 2024

Background/purpose: The effect of direct-acting antiviral agents (DAAs) on hepatocellular carcinoma (HCC) recurrence after curative hepatectomy remains uncertain. This retrospective study aimed to evaluate the effect of sustained virological response (SVR) with DAAs or interferon (IFN) therapy on recurrence and overall survival (OS) after hepatectomy.

Methods: We enrolled 593 patients who underwent curative resections between January 2010 and December 2017. Among them, 186 achieved SVR before hepatectomy: a total of 51 (27.4%) in the DAA-SVR group and 132 (72.6%) in the IFN-based SVR group.

Results: SVR before hepatectomy was an independent predictor of OS, and the 5-year OS rate was significantly higher in the SVR group than that in the non-SVR group (82.2% vs. 63.9%). There were no significant differences in the recurrence rates or OS between DAA and IFN treatments in achieving SVR before hepatectomy, regardless of poor hepatic function in the DAA therapy group.

Conclusions: There was no significant difference in OS and recurrence-free survival (RFS) between the preoperative SVR achieved with DAA and IFN groups in this study, although liver function was significantly worse at the time of surgery in the DAA group compared to the IFN group.

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http://dx.doi.org/10.1002/jhbp.1406DOI Listing

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Article Synopsis
  • The study investigated the long-term outcomes of patients with hepatitis C virus (HCV)-related liver cancer (HCC) who underwent surgery, focusing on those who achieved sustained virologic response (SVR) from antiviral therapy versus those who didn't.
  • A total of 216 patients were analyzed, revealing that those with pre- or post-SVR had better liver health and significantly improved overall survival (OS) and recurrence-free survival (RFS) compared to the non-SVR group.
  • Results suggested that achieving SVR, particularly through direct-acting antiviral (DAA) therapy, was strongly linked to lower recurrence rates and increased survival rates after surgical resection of HCC.
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Methods: 391 patients (1991-2021) treated with resection for hepatocellular carcinoma on Hepatitis C background were divided according to receiving Hepatitis C treatment, treatment type, achievement of sustained virological response (SVR), time of resection pre- (Era 1, 1991-2011) and post-direct acting antivirals introduction (Era 2, 2012-2021). Survival was estimated with Kaplan-Meier curves, Cox regression analysis performed to identify survival predictors.

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Backgrounds: The success of direct-acting antiviral (DAA) therapy provides a cure for patients chronically infected with hepatitis C virus (HCV); however, outcomes after hepatectomy for HCV-associated hepatocellular carcinoma (HCC) before and after DAA introduction remain poorly studied.

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Comparison of postoperative outcomes in cases achieving sustained virological response with direct-acting antiviral and interferon therapy.

J Hepatobiliary Pancreat Sci

May 2024

Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.

Background/purpose: The effect of direct-acting antiviral agents (DAAs) on hepatocellular carcinoma (HCC) recurrence after curative hepatectomy remains uncertain. This retrospective study aimed to evaluate the effect of sustained virological response (SVR) with DAAs or interferon (IFN) therapy on recurrence and overall survival (OS) after hepatectomy.

Methods: We enrolled 593 patients who underwent curative resections between January 2010 and December 2017.

View Article and Find Full Text PDF

Background And Aims: Cirrhotic patients are prone to hypotension during anesthesia. The primary aim of the study was to compare the effects of automated gas control (AGC) of sevoflurane and target-controlled infusion (TCI) of propofol on systemic and cardiac hemodynamics in hepatitis C cirrhotic patients undergoing surgery. The secondary aim was to compare the recovery, complications, and costs between the two groups.

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