Impact of viral eradication by direct-acting antivirals on clinical outcomes after curative treatment for hepatitis C virus-associated hepatocellular carcinoma

Background: It is not clear that antiviral therapy for hepatitis C virus (HCV) after recovery from curative treatment for hepatocellular carcinoma (HCC) has an effect on suppressing recurrence or improving survival rates. Objectives: We analyzed the impact of eradication by interferon (IFN)-free dir...

Full description

Saved in:
Bibliographic Details
Main Authors: Yuko Nagaoki, Kenji Yamaoka, Yasutoshi Fujii, Shinsuke Uchikawa, Hatsue Fujino, Atsushi Ono, Eisuke Murakami, Tomokazu Kawaoka, Daiki Miki, Hiroshi Aikata, Clair Nelson Hayes, Masataka Tsuge, Shiro Oka
Format: Article
Language:English
Published: SAGE Publishing 2025-03-01
Series:Therapeutic Advances in Gastroenterology
Online Access:https://doi.org/10.1177/17562848251324094
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850225531432206336
author Yuko Nagaoki
Kenji Yamaoka
Yasutoshi Fujii
Shinsuke Uchikawa
Hatsue Fujino
Atsushi Ono
Eisuke Murakami
Tomokazu Kawaoka
Daiki Miki
Hiroshi Aikata
Clair Nelson Hayes
Masataka Tsuge
Shiro Oka
author_facet Yuko Nagaoki
Kenji Yamaoka
Yasutoshi Fujii
Shinsuke Uchikawa
Hatsue Fujino
Atsushi Ono
Eisuke Murakami
Tomokazu Kawaoka
Daiki Miki
Hiroshi Aikata
Clair Nelson Hayes
Masataka Tsuge
Shiro Oka
author_sort Yuko Nagaoki
collection DOAJ
description Background: It is not clear that antiviral therapy for hepatitis C virus (HCV) after recovery from curative treatment for hepatocellular carcinoma (HCC) has an effect on suppressing recurrence or improving survival rates. Objectives: We analyzed the impact of eradication by interferon (IFN)-free direct-acting antiviral (DAA) therapy on clinical outcomes of patients with HCV-associated HCC who underwent curative treatment. Design: This was a retrospective study. Methods: We retrospectively reviewed 109 consecutive patients with sustained virologic response with DAA therapy after HCC treatment and analyzed HCC recurrence and overall survival (OS). Among these patients are those with a history of HCC recurrence and curative HCC treatments administered as definitive HCC treatments prior to initiation of DAA therapy. Results: Among 109 patients, 64 received DAA therapy after curative treatment for HCC; the remaining 45 received ⩾2 subsequent treatments for HCC. Cumulative HCC recurrence rates at 1, 3, and 5 years were 23%, 47%, and 56%, respectively. Multivariate analysis identified predictive factors for suppression of HCC recurrence as tumor number (hazard ratio (HR) 2.293 for multiple; p  = 0.006) and number of HCC treatments before DAA therapy (HR 2.928 for ⩾2; p  = 0.001). Among 64 patients who received curative treatment for HCC, cumulative first HCC recurrence rates at 1, 3, and 5 years were 12%, 34%, and 44%, respectively, second recurrence rates were 11%, 28%, and 39%, and third recurrence rates were 0%, 22%, and 53%, respectively; recurrence tended to be suppressed until 3 years. Cumulative OS rates at 3 and 5 years were 87% and 75%, respectively. On multivariate analysis, tumor number (HR 2.452 for single; p  = 0.026) was the only independent predictor of OS. Conclusion: DAA therapy after curative treatment for HCC suppresses HCC recurrence in the long term, but recurrence was higher in patients with a history of many HCC treatments.
format Article
id doaj-art-b321dd6d70d6404ab7c3a237ae8bfb06
institution OA Journals
issn 1756-2848
language English
publishDate 2025-03-01
publisher SAGE Publishing
record_format Article
series Therapeutic Advances in Gastroenterology
spelling doaj-art-b321dd6d70d6404ab7c3a237ae8bfb062025-08-20T02:05:20ZengSAGE PublishingTherapeutic Advances in Gastroenterology1756-28482025-03-011810.1177/17562848251324094Impact of viral eradication by direct-acting antivirals on clinical outcomes after curative treatment for hepatitis C virus-associated hepatocellular carcinomaYuko NagaokiKenji YamaokaYasutoshi FujiiShinsuke UchikawaHatsue FujinoAtsushi OnoEisuke MurakamiTomokazu KawaokaDaiki MikiHiroshi AikataClair Nelson HayesMasataka TsugeShiro OkaBackground: It is not clear that antiviral therapy for hepatitis C virus (HCV) after recovery from curative treatment for hepatocellular carcinoma (HCC) has an effect on suppressing recurrence or improving survival rates. Objectives: We analyzed the impact of eradication by interferon (IFN)-free direct-acting antiviral (DAA) therapy on clinical outcomes of patients with HCV-associated HCC who underwent curative treatment. Design: This was a retrospective study. Methods: We retrospectively reviewed 109 consecutive patients with sustained virologic response with DAA therapy after HCC treatment and analyzed HCC recurrence and overall survival (OS). Among these patients are those with a history of HCC recurrence and curative HCC treatments administered as definitive HCC treatments prior to initiation of DAA therapy. Results: Among 109 patients, 64 received DAA therapy after curative treatment for HCC; the remaining 45 received ⩾2 subsequent treatments for HCC. Cumulative HCC recurrence rates at 1, 3, and 5 years were 23%, 47%, and 56%, respectively. Multivariate analysis identified predictive factors for suppression of HCC recurrence as tumor number (hazard ratio (HR) 2.293 for multiple; p  = 0.006) and number of HCC treatments before DAA therapy (HR 2.928 for ⩾2; p  = 0.001). Among 64 patients who received curative treatment for HCC, cumulative first HCC recurrence rates at 1, 3, and 5 years were 12%, 34%, and 44%, respectively, second recurrence rates were 11%, 28%, and 39%, and third recurrence rates were 0%, 22%, and 53%, respectively; recurrence tended to be suppressed until 3 years. Cumulative OS rates at 3 and 5 years were 87% and 75%, respectively. On multivariate analysis, tumor number (HR 2.452 for single; p  = 0.026) was the only independent predictor of OS. Conclusion: DAA therapy after curative treatment for HCC suppresses HCC recurrence in the long term, but recurrence was higher in patients with a history of many HCC treatments.https://doi.org/10.1177/17562848251324094
spellingShingle Yuko Nagaoki
Kenji Yamaoka
Yasutoshi Fujii
Shinsuke Uchikawa
Hatsue Fujino
Atsushi Ono
Eisuke Murakami
Tomokazu Kawaoka
Daiki Miki
Hiroshi Aikata
Clair Nelson Hayes
Masataka Tsuge
Shiro Oka
Impact of viral eradication by direct-acting antivirals on clinical outcomes after curative treatment for hepatitis C virus-associated hepatocellular carcinoma
Therapeutic Advances in Gastroenterology
title Impact of viral eradication by direct-acting antivirals on clinical outcomes after curative treatment for hepatitis C virus-associated hepatocellular carcinoma
title_full Impact of viral eradication by direct-acting antivirals on clinical outcomes after curative treatment for hepatitis C virus-associated hepatocellular carcinoma
title_fullStr Impact of viral eradication by direct-acting antivirals on clinical outcomes after curative treatment for hepatitis C virus-associated hepatocellular carcinoma
title_full_unstemmed Impact of viral eradication by direct-acting antivirals on clinical outcomes after curative treatment for hepatitis C virus-associated hepatocellular carcinoma
title_short Impact of viral eradication by direct-acting antivirals on clinical outcomes after curative treatment for hepatitis C virus-associated hepatocellular carcinoma
title_sort impact of viral eradication by direct acting antivirals on clinical outcomes after curative treatment for hepatitis c virus associated hepatocellular carcinoma
url https://doi.org/10.1177/17562848251324094
work_keys_str_mv AT yukonagaoki impactofviraleradicationbydirectactingantiviralsonclinicaloutcomesaftercurativetreatmentforhepatitiscvirusassociatedhepatocellularcarcinoma
AT kenjiyamaoka impactofviraleradicationbydirectactingantiviralsonclinicaloutcomesaftercurativetreatmentforhepatitiscvirusassociatedhepatocellularcarcinoma
AT yasutoshifujii impactofviraleradicationbydirectactingantiviralsonclinicaloutcomesaftercurativetreatmentforhepatitiscvirusassociatedhepatocellularcarcinoma
AT shinsukeuchikawa impactofviraleradicationbydirectactingantiviralsonclinicaloutcomesaftercurativetreatmentforhepatitiscvirusassociatedhepatocellularcarcinoma
AT hatsuefujino impactofviraleradicationbydirectactingantiviralsonclinicaloutcomesaftercurativetreatmentforhepatitiscvirusassociatedhepatocellularcarcinoma
AT atsushiono impactofviraleradicationbydirectactingantiviralsonclinicaloutcomesaftercurativetreatmentforhepatitiscvirusassociatedhepatocellularcarcinoma
AT eisukemurakami impactofviraleradicationbydirectactingantiviralsonclinicaloutcomesaftercurativetreatmentforhepatitiscvirusassociatedhepatocellularcarcinoma
AT tomokazukawaoka impactofviraleradicationbydirectactingantiviralsonclinicaloutcomesaftercurativetreatmentforhepatitiscvirusassociatedhepatocellularcarcinoma
AT daikimiki impactofviraleradicationbydirectactingantiviralsonclinicaloutcomesaftercurativetreatmentforhepatitiscvirusassociatedhepatocellularcarcinoma
AT hiroshiaikata impactofviraleradicationbydirectactingantiviralsonclinicaloutcomesaftercurativetreatmentforhepatitiscvirusassociatedhepatocellularcarcinoma
AT clairnelsonhayes impactofviraleradicationbydirectactingantiviralsonclinicaloutcomesaftercurativetreatmentforhepatitiscvirusassociatedhepatocellularcarcinoma
AT masatakatsuge impactofviraleradicationbydirectactingantiviralsonclinicaloutcomesaftercurativetreatmentforhepatitiscvirusassociatedhepatocellularcarcinoma
AT shirooka impactofviraleradicationbydirectactingantiviralsonclinicaloutcomesaftercurativetreatmentforhepatitiscvirusassociatedhepatocellularcarcinoma