The association between antiviral therapy and 10-year overall survival of patients undergoing liver resection for hepatitis C virus- or hepatitis B virus-related hepatocellular carcinoma.

The efficacy of antiviral therapy against hepatitis C virus (HCV) and hepatitis B virus (HBV), following liver resection (LR) for hepatocellular carcinoma (HCC), has been studied extensively. However, its long-term overall survival (OS) benefit remains to be conclusively demonstrated. This retrospective cohort study included 1121 patients (777 with HBV-related HCC and 344 with HCV-related HCC) who underwent LR. The primary outcome was 10-year OS. The indication for antiviral therapy was serum HBV DNA > 2000 IU/ml in patients with HBV-related HCC and detectable serum HCV RNA in patients with HCV-related HCC. After propensity score matching, the 10-year OS of the antiviral-treated group was 58% and that of the untreated group was 25% (p < 0.001) in the HCV-infected cohort. The 10-year OS of the antiviral-treated group was 62% and that of the untreated group was 61% (p = 0.917) in the HBV-infected cohort. Antiviral therapy was associated with improved 10-year OS of patients with HCV-related HCC and viremia who underwent LR. In contrast, the 10-year OS of patients undergoing LR for HBV-related HCC who were treated with antiviral therapy based on serum HBV-DNA > 2000 IU/ml was similar to that of untreated patients.