丙型肝炎感染患者实现持续病毒学应答并接受肝细胞癌根治性治疗的长期预后

Long-Term Outcomes of Hepatitis-C-Infected Patients Achieving a Sustained Virological Response and Undergoing Radical Treatment for Hepatocellular Carcinoma.

作者信息

Kunimoto Hideo, Ikeda Kenji, Sorin Yushi, Fujiyama Shunichiro, Kawamura Yusuke, Kobayashi Masahiro, Sezaki Hitomi, Hosaka Tetsuya, Akuta Norio, Saitoh Satoshi, Suzuki Fumitaka, Suzuki Yoshiyuki, Arase Yasuji, Kumada Hiromitsu

机构信息

Department of Hepatology, Toranomon Hospital, Tokyo, Japan.

出版信息

Oncology. 2016;90(3):167-75. doi: 10.1159/000443891. Epub 2016 Feb 23.

DOI:10.1159/000443891

PMID:26901157

Abstract

BACKGROUND AND AIMS

A sustained virological response (SVR) decreases the incidence of hepatocellular carcinoma (HCC) in patients with hepatitis C. We investigated the long-term outcomes of patients who developed HCC after achieving SVR with interferon therapy.

PATIENTS

Of 75 patients who developed HCC after SVR, 40 patients underwent radical therapies (SVR group). From 436 patients undergoing surgical resection for hepatitis C virus-positive HCC, 80 patients were randomly chosen as a control cohort, after adjusting for age, gender, and extent of hepatic fibrosis (non-SVR group). Patients were observed for a median of 5.08 years.

RESULTS

HCC recurrence was found in 16 SVR patients and in 66 non-SVR patients. The respective HCC recurrence rates of SVR and non-SVR patients were 23 and 56% at 3 years, 42 and 77% at 5 years, and 53 and 90% at 10 years (p = 0.001). The respective overall survival rates in the SVR and non-SVR groups were 93 and 68% at 5 years, 88 and 34% at 10 years, and 53 and 21% at 15 years (p = 0.001).

CONCLUSION

Although SVR patients had a significantly lower HCC recurrence rate than the non-SVR patients, the cumulative recurrence rate of SVR patients increased to 86% at 15 years.

摘要

背景与目的

持续病毒学应答（SVR）可降低丙型肝炎患者肝细胞癌（HCC）的发生率。我们调查了接受干扰素治疗实现SVR后发生HCC的患者的长期预后。

患者

在75例SVR后发生HCC的患者中，40例接受了根治性治疗（SVR组）。在436例因丙型肝炎病毒阳性HCC接受手术切除的患者中，在调整年龄、性别和肝纤维化程度后，随机选择80例作为对照队列（非SVR组）。对患者进行了中位5.08年的观察。

结果

16例SVR患者和66例非SVR患者出现HCC复发。SVR和非SVR患者3年时的HCC复发率分别为23%和56%，5年时分别为42%和77%，10年时分别为53%和90%（p = 0.001）。SVR组和非SVR组5年时的总生存率分别为93%和68%，10年时分别为88%和34%，15年时分别为53%和21%（p = 0.001）。