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Direct-Acting Antivirals Improve Treatment Outcomes in Patients with Hepatitis C Virus-Related Hepatocellular Carcinoma Treated with Transarterial Chemoembolization: A Nationwide, Multi-center, Retrospective Cohort Study
- Title
- Direct-Acting Antivirals Improve Treatment Outcomes in Patients with Hepatitis C Virus-Related Hepatocellular Carcinoma Treated with Transarterial Chemoembolization: A Nationwide, Multi-center, Retrospective Cohort Study
- Authors
- Hyun H.K.; Cho E.J.; Park S.Y.; Hong Y.M.; Kim S.S.; Kim H.Y.; Heo N.-Y.; Park J.G.; Sinn D.H.; Kang W.; Jeong S.W.; Song M.J.; Park H.; Lee D.; Lee Y.S.; Cho S.B.; An C.S.; Rhee H.J.; Lee H.W.; Kim B.K.; Park J.Y.; Kim D.Y.; Ahn S.H.; Han K.-H.; Lee J.-H.; Yu S.J.; Kim Y.J.; Yoon J.-H.; Tak W.Y.; Kweon Y.O.; Yoon K.T.; Cho M.; Cheong J.Y.; Park S.H.; Kim S.U.; The Korean TACE Study Group
- Ewha Authors
- 김휘영
- SCOPUS Author ID
- 김휘영
- Issue Date
- 2021
- Journal Title
- Digestive Diseases and Sciences
- ISSN
- 0163-2116
- Citation
- Digestive Diseases and Sciences vol. 66, no. 7, pp. 2427 - 2438
- Keywords
- Direct-acting antiviral; Hepatitis C virus; Hepatocellular carcinoma; Progression; Transarterial chemoembolization
- Publisher
- Springer
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Background and Aims: The influence of direct-acting antivirals (DAAs) on chronic hepatitis C (CHC)-related hepatocellular carcinoma (HCC) remains controversial. We investigated the effect of eradicating CHC using DAAs on treatment outcomes in patients with CHC-related HCC treated with transarterial chemoembolization (TACE). Methods: This nationwide, multi-center, retrospective study recruited patients with CHC-related HCC treated with TACE as the first-line anti-cancer treatment, and who achieved a sustained virological response (SVR) using DAAs (DAA group) between 2006 and 2017. Patients achieving an SVR following interferon-based treatment (IFN group) and those without treatment (control group) were also recruited for comparison. Results: A total of 425 patients were eligible for the study. Of these, 356 (83.8%), 26 (6.1%), and 43 (10.1%) were allocated to the control, IFN, and DAA groups, respectively. A multivariate analysis showed that liver cirrhosis, segmental portal vein thrombosis, and larger maximal tumor size independently predicted an increased risk of progression (all p < 0.05), whereas, the DAA group (vs. IFN and control groups) independently predicted a reduced risk of progression (hazard ratio (HR) = 0.630, 95% confidence interval 0.411–0.966, p = 0.034). The cumulative incidence rate of HCC progression in the DAA group was significantly lower than that in the IFN and control groups (p = 0.033, log-rank test). In addition, the DAA group (vs. IFN and control groups) was independently associated with a reduced risk of mortality (p = 0.042). Conclusions: DAA treatment provided significantly prolonged progression-free survival in patients with CHC-related HCC treated with TACE compared to that in patients administered IFN or no treatment. © 2020, Springer Science+Business Media, LLC, part of Springer Nature.
- DOI
- 10.1007/s10620-020-06533-7
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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