Barcelona Clinic Liver Cancer (BCLC) Group, Liver Unit, Hospital Clínic Barcelona, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain.
Centro de Investigación Médica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, 28029 Madrid, Spain.
Viruses. 2019 May 1;11(5):406. doi: 10.3390/v11050406.
The risk of hepatocellular carcinoma recurrence is universal regardless of the treatment modality applied, and secondary prevention is still an unmet issue even though the elimination of hepatitis C (HCV) with direct antiviral agents (DAAs) was expected to be one of the new options. Unfortunately, the impact of DAAs on hepatocellular carcinoma (HCC) development (de novo and recurrence) is still controversial. Since the first publication on the subject in 2016, almost all groups worldwide have carried out research in this field with hundreds of publications now available. This revision is focused on the impact of DAAs on HCC recurrence and aims to discuss the potential underlying mechanisms and host factors pointing out the time association phenomenon between DAA treatment and HCC recurrence. Moreover, we comment on the methodological issues that could affect the different interpretations of the published results. In conclusion, this is an area of research with potential in the understanding of the impact of factors not previously considered, and may also help change hepatocarcinogenesis tenets, such as the belief that the elimination of HCV should be used as a second prevention treatment.
无论应用何种治疗方式，肝细胞癌复发的风险都是普遍存在的，即使人们期望直接抗病毒药物 (DAA) 消除丙型肝炎 (HCV) 成为新的选择之一，但二级预防仍然是一个尚未解决的问题。不幸的是，DAA 对肝细胞癌 (HCC) 发展（新发和复发）的影响仍存在争议。自 2016 年首次发表相关研究以来，全球几乎所有的研究小组都开展了该领域的研究，目前已有数百篇论文发表。本次修订主要集中在 DAA 对 HCC 复发的影响上，旨在讨论潜在的潜在机制和宿主因素，并指出 DAA 治疗与 HCC 复发之间的时间关联现象。此外，我们还对可能影响对已发表结果的不同解释的方法学问题进行了评论。总之，这是一个具有潜在研究价值的领域，可以帮助我们更好地理解以前未被考虑的因素的影响，也可能有助于改变肝癌发生的基本原则，例如消除 HCV 应作为二级预防治疗的观点。
