Direct-Acting Antivirals Improve Treatment Outcomes in Patients with Hepatitis C Virus-Related Hepatocellular Carcinoma
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ORIGINAL ARTICLE
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 Hye Kyung Hyun1 · Eun Ju Cho2 · Soo Young Park3 · Young Mi Hong4 · Soon Sun Kim5 · Hwi Young Kim6 · Nae‑Yun Heo7 · Jung Gil Park8 · Dong Hyun Sinn9 · Wonseok Kang9 · Song Won Jeong10 · Myeong Jun Song11 · Hana Park12 · Danbi Lee12 · Yong Sun Lee13 · Sung Bum Cho14 · Chan Sik An1 · Hyung Jin Rhee1 · Hyun Woong Lee1 · Beom Kyung Kim1 · Jun Yong Park1 · Do Young Kim1 · Sang Hoon Ahn1 · Kwang‑Hyub Han1 · Jeong‑Hoon Lee2 · Su Jong Yu2 · Yoon Jun Kim2 · Jung‑Hwan Yoon2 · Won Young Tak3 · Young Oh Kweon3 · Ki Tae Yoon4 · Mong Cho4 · Jae Youn Cheong5 · Seung Ha Park7 · Seung Up Kim1 · The Korean TACE Study Group Received: 27 March 2020 / Accepted: 3 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
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 3.25), non-SVR, and higher tumor numbers independently predicted HCC recurrence. Ikeda et al. [16] showed that DAA therapy significantly decreased recurrence rates when administered after initial curative HCC therapy compared to the rate in untreated patients. In addition, a recent meta-analysis of the French ANRS cohort study showed no difference in the recurrence rates based on DAA administration among patients previously treated with curative HCC therapies [17]. However, no data have been reported regarding the influence of DAA treatment on patients with CHC-related HCC who were administered palliative treatments. Thus, the aim of this nationwide, multi-center, retrospective cohort study was to investigate whether CHC eradication using DAAs influenced treatment outcomes in patients with CHC-related HCC treated with transarterial chemoembolization (TACE).
Methods Study Design and Participants Patients with SVR and HCV-related HCC who were administered TACE as the first-
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