干扰素治疗持续病毒学应答对丙型肝炎病毒相关肝细胞癌复发的影响。
Impact of Sustained Virological Response to Interferon Therapy on Recurrence of Hepatitis C Virus-Related Hepatocellular Carcinoma.
机构信息
Hepatobiliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
出版信息
Ann Surg Oncol. 2017 Oct;24(11):3196-3202. doi: 10.1245/s10434-017-6008-y. Epub 2017 Jul 13.
BACKGROUND
Although achieving a sustained virological response (SVR) in hepatitis C virus (HCV) infection is recognized as improving liver function and reducing hepatocellular carcinoma (HCC) development, its impact on HCC recurrence is unclear. This study investigated how preoperative SVR achievement by interferon treatment affects HCC recurrence in patients undergoing hepatic resection.
METHODS
The study subjects were 521 patients with HCV infection who underwent initial and curative hepatic resection for HCC. To adjust for confounding factors between the SVR and non-SVR groups, propensity score-matching analysis was performed.
RESULTS
After propensity score matching, 45 of the 49 patients in the SVR group, and an equal number of the 472 patients in the non-SVR group, were matched. The two groups had similar distributions of clinicopathological characteristics. In the matched cohort, the 3-, 5-, and 7-year recurrence-free survival rates after surgery were 56, 45, and 37%, respectively, in the SVR group, and 34, 23, and 7.2%, respectively, in the non-SVR group (p = 0.033). Additionally, the 3-, 5-, and 7-year overall survival rates after surgery were 82, 80, and 75%, respectively, in the SVR group, and 78, 64, and 44%, respectively, in the non-SVR group (p = 0.065). The 1- and 2-year cumulative recurrence rates in the early phase showed no significant difference between the SVR and non-SVR groups (p = 0.27). however, the 3-, 5-, and 7-year cumulative recurrence rates in the late phase were 14, 32, and 43%, respectively, in the SVR group, and 33, 55, and 86%, respectively, in the non-SVR group (p = 0.037).
CONCLUSION
Achievement of SVR may reduce postoperative recurrence after hepatic resection.
背景
虽然丙型肝炎病毒 (HCV) 感染患者实现持续病毒学应答 (SVR) 被认为可改善肝功能并降低肝细胞癌 (HCC) 的发生，但 SVR 对 HCC 复发的影响尚不清楚。本研究旨在探讨干扰素治疗获得的术前 SVR 是否影响接受肝切除术的 HCC 患者的 HCC 复发。
方法
本研究的对象是 521 例 HCV 感染初治和根治性肝切除治疗 HCC 的患者。为了调整 SVR 组和非 SVR 组之间的混杂因素，进行了倾向评分匹配分析。
结果
经过倾向评分匹配后，49 例 SVR 组患者中的 45 例与 472 例非 SVR 组患者中的 45 例相匹配。两组患者的临床病理特征分布相似。在匹配队列中，SVR 组患者术后 3、5 和 7 年无复发生存率分别为 56%、45%和 37%，而非 SVR 组患者分别为 34%、23%和 7.2%（p=0.033）。此外，SVR 组患者术后 3、5 和 7 年总生存率分别为 82%、80%和 75%，而非 SVR 组患者分别为 78%、64%和 44%（p=0.065）。SVR 组和非 SVR 组在早期阶段的 1 年和 2 年累积复发率没有显著差异（p=0.27）。然而，在晚期阶段，SVR 组的 3 年、5 年和 7 年累积复发率分别为 14%、32%和 43%，而非 SVR 组分别为 33%、55%和 86%（p=0.037）。
结论
获得 SVR 可能会降低肝切除术后的复发率。
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