Antiviral Therapy Utilization and 10-Year Outcomes in Resected Hepatitis B Virus- and Hepatitis C Virus-Related Hepatocellular Carcinoma.

Autor:	Huang DQ; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.; Division of Gastroenterology and Hepatology, National University Health System, Singapore, Singapore., Hoang JK; Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA., Kamal R; Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA.; Meharry Medical College, Nashville, TN., Tsai PC; Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.; Hepatitis Research Center, College of Medicine and Cohort Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan., Toyoda H; Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan., Yeh ML; Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.; Hepatitis Research Center, College of Medicine and Cohort Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan., Yasuda S; Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan., Leong J; Henry D. Janowitz Division of Gastroenterology, Mt. Sinai Health System, New York, NY., Maeda M; Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA., Huang CF; Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.; Hepatitis Research Center, College of Medicine and Cohort Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan., Won Jun D; Department of Internal Medicine, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, South Korea., Ishigami M; Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan., Tanaka Y; Department of Gastroenterology and Hepatology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan., Uojima H; Department of Gastroenterology, Internal Medicine, Kitasato University School of Medicine, Sagamihara., Ogawa E; Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan., Abe H; Division of Gastroenterology and Hepatology, Shinmatsudo Central General Hospital, Chiba, Japan., Hsu YC; Division of Gastroenterology of Hepatology, E-Da Cancer Hospital/I-Shou University, Kaohsiung, Taiwan., Tseng CH; Division of Gastroenterology of Hepatology, E-Da Cancer Hospital/I-Shou University, Kaohsiung, Taiwan., Alsudaney M; Karsh Division of Gastroenterology and Hepatology, Comprehensive Transplant Center, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA., Yang JD; Karsh Division of Gastroenterology and Hepatology, Comprehensive Transplant Center, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA., Yoshimaru Y; Department of Gastroenterology and Hepatology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan., Suzuki T; Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan., Liu JK; University of Washington, Seattle, WA., Landis C; Division of Gastroenterology, Kaiser Permanente, Seattle, WA., Dai CY; Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.; Hepatitis Research Center, College of Medicine and Cohort Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan., Huang JF; Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.; Hepatitis Research Center, College of Medicine and Cohort Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan., Chuang WL; Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.; Hepatitis Research Center, College of Medicine and Cohort Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan., Schwartz M; Recanati-Miller Transplantation Institute, Mount Sinai School of Medicine, New York, NY., Dan YY; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.; Division of Gastroenterology and Hepatology, National University Health System, Singapore, Singapore., Esquivel C; Department of Surgery, Stanford University Medical Center, Palo Alto, CA., Bonham A; Department of Surgery, Stanford University Medical Center, Palo Alto, CA., Yu ML; Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.; Hepatitis Research Center, College of Medicine and Cohort Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan.; School of Medicine and Doctoral Program of Clinical and Experimental Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver Disease, National Sun Yat-sen University, Kaohsiung, Taiwan., Nguyen MH; Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA.; Department of Epidemiology and Population Health, Stanford University, Palo Alto, CA.
Jazyk:	angličtina
Zdroj:	Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 2024 Mar 01; Vol. 42 (7), pp. 790-799. Date of Electronic Publication: 2024 Jan 04.
DOI:	10.1200/JCO.23.00757
Abstrakt:	Purpose: There are limited data on antiviral treatment utilization and its impact on long-term outcomes of hepatitis B virus (HBV)- and hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) after hepatic resection. We aimed to determine the utilization and impact of antivirals in HBV- and HCV-related HCC. Methods: This cohort study included 1,906 participants (1,054 HBV-related HCC and 852 HCV-related HCC) from 12 international sites. All participants had HBV- or HCV-related HCC and underwent curative surgical resection. The primary outcome was the utilization of antiviral therapy, and the secondary outcome was long-term overall survival (OS). Results: The mean (±standard deviation [SD]) age was 62.1 (±11.3) years, 74% were male, and 84% were Asian. A total of 47% of the total cohort received antiviral therapy during a mean (±SD) follow-up of 5.0 (±4.3) years. The overall antiviral utilization for participants with HBV-related HCC was 57% and declined over time, from 65% before 2010, to 60% from 2010 to 2015, to 47% beyond 2015, P < .0001. The overall utilization of antivirals for HCV-related HCC was 35% and increased over time, from 24% before 2015 to 74% from 2015 and beyond, P < .0001. The 10-year OS was lower in untreated participants for both HBV (58% v 61%) and HCV participants (38% v 82%; both P < .0001). On multivariable Cox regression analysis adjusted for relevant confounders, antiviral therapy initiated before or within 6 months of HCC diagnosis was independently associated with lower mortality in both HBV- (adjusted hazard ratio [aHR], 0.60 [95% CI, 0.43 to 0.83]; P = .002) and HCV-related HCC (aHR, 0.18 [95% CI, 0.11 to 0.31]; P < .0001). Conclusion: Antiviral therapy is associated with long-term survival in people with HBV- or HCV-related HCC who undergo curative resection but is severely underutilized.
Databáze:	MEDLINE
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