Updates in surgery · 2026
Sustained virological response improved survival outcomes after curative resection in patients with hepatitis C virus-related hepatocellular carcinoma in the era of direct‑acting antiviral therapy.
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Yen Yi-Hao, Yong Chee-Chien, Hung Chao-Hung, Chen Chien-Hung, Lu Sheng-Nan, Hu Tsung-Hui, Wang Jing-Houng, Liu Yueh-Wei, Li Wei-Feng, Wang Chih-Chi, Lin Chih-Yun
Аннотация
BACKGROUND AND AIM: The impact of sustained virological response (SVR) on outcomes of patients with hepatocellular carcinoma (HCC) undergoing liver resection (LR) was assessed.
METHODS: This retrospective cohort study included 344 patients with hepatitis C virus (HCV)-related HCC who underwent LR. Patients were divided into three groups: preoperatively achieving SVR (pre-SVR); postoperatively achieving SVR (post-SVR); and not achieving SVR (non-SVR).
RESULTS: 145 patients received direct-acting antivirals, 76 received interferon-based therapy, and 123 were untreated. 95 patients were pre-SVR, 87 were post-SVR, and 162 were non-SVR, including untreated patients. Five-year overall survival was 83% in the pre-SVR group, 92% in the post-SVR group, and 50% in the non-SVR group (p < 0.001). Pre-SVR (adjusted HR (aHR) 0.35; 95% CI 0.19-0.62; p < 0.001) and post-SVR (aHR 0.18; 95% CI 0.09-0.36; p < 0.001) were independent predictors of mortality. Five-year recurrence-free survival was 75% in the pre-SVR group, 55% in the post-SVR group, and 45% in the non-SVR group (p < 0.001). Pre-SVR (aHR 0.45; 95% CI 0.28-0.73; p = 0.001) was an independent predictor of recurrence, whereas post-SVR (aHR 0.84; 95% CI 0.57-1.24; p = 0.37) was not.
CONCLUSIONS: Achieving SVR before or after LR decreased the mortality risk and achieving SVR before LR decreased the recurrence risk of patients with HCV-related HCC undergoing LR.
METHODS: This retrospective cohort study included 344 patients with hepatitis C virus (HCV)-related HCC who underwent LR. Patients were divided into three groups: preoperatively achieving SVR (pre-SVR); postoperatively achieving SVR (post-SVR); and not achieving SVR (non-SVR).
RESULTS: 145 patients received direct-acting antivirals, 76 received interferon-based therapy, and 123 were untreated. 95 patients were pre-SVR, 87 were post-SVR, and 162 were non-SVR, including untreated patients. Five-year overall survival was 83% in the pre-SVR group, 92% in the post-SVR group, and 50% in the non-SVR group (p < 0.001). Pre-SVR (adjusted HR (aHR) 0.35; 95% CI 0.19-0.62; p < 0.001) and post-SVR (aHR 0.18; 95% CI 0.09-0.36; p < 0.001) were independent predictors of mortality. Five-year recurrence-free survival was 75% in the pre-SVR group, 55% in the post-SVR group, and 45% in the non-SVR group (p < 0.001). Pre-SVR (aHR 0.45; 95% CI 0.28-0.73; p = 0.001) was an independent predictor of recurrence, whereas post-SVR (aHR 0.84; 95% CI 0.57-1.24; p = 0.37) was not.
CONCLUSIONS: Achieving SVR before or after LR decreased the mortality risk and achieving SVR before LR decreased the recurrence risk of patients with HCV-related HCC undergoing LR.