Palermo, Italy.
Bologna, Italy.
Aliment Pharmacol Ther. 2017 Jan;45(1):160-168. doi: 10.1111/apt.13821. Epub 2016 Oct 28.
In HCV-infected cirrhotic patients with successfully treated early hepatocellular carcinoma (HCC), the time to HCC recurrence and the effects of sustained viral eradication (SVR) by interferon (IFN)-based or IFN-free regimens on HCC recurrence remain unclear.
To perform an indirect comparison of time to recurrence (TTR) in patients with successfully treated early HCC and active HCV infection with those of patients with SVR by IFN-based and by IFN-free regimens.
We evaluated 443 patients with HCV-related cirrhosis and Barcelona Clinic Liver Cancer Stage A/0 HCC who had a complete radiological response after curative resection or ablation. Active HCV infection was present in 328, selected from the Italian Liver Cancer group cohort; 58 patients had SVR achieved by IFN-free regimens after HCC cure, and 57 patients had SVR achieved by IFN-based regimens after HCC cure. Individual data of patients in the last two groups were extracted from available publications.
TTR by Kaplan-Meier curve was significantly lower in patients with active HCV infection compared with those with SVR both by IFN-free (P = 0.02) and by IFN-based (P < 0.001) treatments. TTR was similar in patients with SVR by IFN-free or by IFN-based (P = 0.49) strategies.
In HCV-infected, successfully treated patients with early HCC, SVR obtained by IFN-based or IFN-free regimens significantly reduce tumour recurrence without differences related to the anti-viral strategy used.
在成功治疗早期肝细胞癌（HCC）的 HCV 感染性肝硬化患者中，HCC 复发的时间以及干扰素（IFN）为基础或无 IFN 方案的持续病毒清除（SVR）对 HCC 复发的影响尚不清楚。
对成功治疗的早期 HCC 和活跃 HCV 感染患者与 SVR 的 IFN 为基础和无 IFN 方案患者的复发时间（TTR）进行间接比较。
我们评估了 443 例 HCV 相关肝硬化和巴塞罗那临床肝癌分期 A/0 HCC 患者，这些患者在根治性切除或消融后有完全的影像学反应。328 例来自意大利肝癌组队列，存在活跃的 HCV 感染；58 例患者在 HCC 治愈后通过无 IFN 方案实现了 SVR，57 例患者在 HCC 治愈后通过 IFN 方案实现了 SVR。后两组患者的个体数据从可用文献中提取。
通过 Kaplan-Meier 曲线，与 IFN 为基础治疗相比，活跃 HCV 感染患者的 TTR 明显更低（P = 0.02）；与 IFN 为基础治疗相比，无 IFN 治疗患者的 TTR 也明显更低（P < 0.001）。无 IFN 或 IFN 为基础治疗的 SVR 患者的 TTR 相似（P = 0.49）。
在成功治疗的早期 HCC 的 HCV 感染患者中，IFN 为基础或无 IFN 方案的 SVR 显著降低了肿瘤复发率，与所使用的抗病毒策略无关。
