Tanaka Shogo, Noda Takehiro, Komeda Koji, Yasuda Satoshi, Ueno Masaki, Mori Haruki, Kosaka Hisashi, Morimura Ryo, Shinkawa Hiroji, Sekiguchi Naoko, Ikoma Hisashi, Ishizawa Takeaki, Kaibori Masaki
Department of Hepato-Biliary-Pancreatic Surgery, Graduate School of Medicine, Osaka Metropolitan University, Osaka 545-8585, Osaka, Japan.
Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita 565-0871, Osaka, Japan.
Cancers (Basel). 2025 Jun 11;17(12):1946. doi: 10.3390/cancers17121946.
: Direct-acting antiviral (DAA) therapy, which achieves a high sustained virological response (SVR) rate, has been established as a standard treatment for patients with hepatitis C virus (HCV) infection. However, the risk factors for postoperative recurrence in patients with HCV-related hepatocellular carcinoma (HCC) detected after the achievement of an SVR by DAAs are unknown. : The clinical records of 95 patients with initial HCV-related HCC detected after DAA-SVR achievement, who underwent liver resection between September 2014 and December 2020, were retrospectively reviewed. Patients with major vascular invasion and/or SVR achievement induced by interferon-based therapy were excluded. In this study, the patients were divided into two groups according to their alcohol intake status: without alcohol abuse (<80 g of ethanol each day for at least 5 years, n = 85) and with (continuous) alcohol abuse (n = 10). The risk factors for recurrence after liver resection were investigated, with special reference to the alcohol intake status. : The 3- and 5-year disease-free survival (DFS) rates after liver resection were 68.7% and 55.3%, respectively. Univariate and multivariate analyses identified alcohol abuse [hazard ratio (HR) 3.36, = 0.004] and tumor size (HR 2.53, = 0.010) as independent risk factors for postoperative recurrence. The 3- and 5-year postoperative DFS rates were 72.2% and 61.5% for patients without alcohol abuse and 40.0% and 13.3% for those with alcohol abuse ( = 0.001). : Continuous alcohol abuse is a risk factor for recurrence after surgery of HCC detected after the achievement of DAA-SVR.
直接抗病毒（DAA）疗法可实现较高的持续病毒学应答（SVR）率，已成为丙型肝炎病毒（HCV）感染患者的标准治疗方法。然而，DAA实现SVR后检测出的HCV相关肝细胞癌（HCC）患者术后复发的危险因素尚不清楚。
回顾性分析了2014年9月至2020年12月期间95例在DAA-SVR实现后首次检测出HCV相关HCC并接受肝切除术患者的临床记录。排除有大血管侵犯和/或基于干扰素治疗诱导实现SVR的患者。在本研究中，根据患者的酒精摄入状况将其分为两组：无酒精滥用（每天乙醇摄入量<80 g，至少持续5年，n = 85）和有（持续）酒精滥用（n = 10）。特别参照酒精摄入状况，研究肝切除术后复发的危险因素。
肝切除术后3年和5年无病生存率（DFS）分别为68.7%和55.3%。单因素和多因素分析确定酒精滥用[风险比（HR）3.36，P = 0.004]和肿瘤大小（HR 2.53，P = 0.010）是术后复发的独立危险因素。无酒精滥用患者的术后3年和5年DFS率分别为72.2%和61.5%，有酒精滥用患者分别为40.0%和13.3%（P = 0.001）。
持续酒精滥用是DAA-SVR实现后检测出的HCC手术后复发的危险因素。
