Effects of Achieving SVR on Clinical Characteristics and Surgical Outcomes in Patients Who Developed Early-Stage HCV-Related Hepatocellular Carcinoma and Received Curative Resection: Preoperative versus Postoperative SVR

Po-Yao Hsu; Po-Cheng Liang; Ching-I Huang; Meng-Hsuan Hsieh; Yi-Shan Tsai; Tzu-Chun Lin; Ming-Lun Yeh; Chung-Feng Huang; Chih-Wen Wang; Tyng-Yuan Jang; Yi-Hung Lin; Zu-Yau Lin; Wan-Long Chuang; Chia-Yen Dai

doi:10.3390/v14112412

Effects of Achieving SVR on Clinical Characteristics and Surgical Outcomes in Patients Who Developed Early-Stage HCV-Related Hepatocellular Carcinoma and Received Curative Resection: Preoperative versus Postoperative SVR

Viruses. 2022 Oct 31;14(11):2412. doi: 10.3390/v14112412.

Authors

Po-Yao Hsu¹, Po-Cheng Liang¹, Ching-I Huang^{1

2}, Meng-Hsuan Hsieh^{1

2

3

4}, Yi-Shan Tsai¹, Tzu-Chun Lin¹, Ming-Lun Yeh^{1

2}, Chung-Feng Huang^{1

2

3}, Chih-Wen Wang^{1

2}, Tyng-Yuan Jang¹, Yi-Hung Lin¹, Zu-Yau Lin^{1

2}, Wan-Long Chuang^{1

2}, Chia-Yen Dai^{1

2

3

5

6}

Affiliations

¹ Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
² Faculty of Internal Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
³ Department of Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
⁴ College of Medicine, National Sun Yat-sen University, Kaohsiung 807, Taiwan.
⁵ College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 912, Taiwan.
⁶ Drug Development and Value Creation Research Center, Kaohsiung Medical University, Kaohsiung 807, Taiwan.

Abstract

The high accessibility to healthcare and increasing awareness of hepatocellular carcinoma (HCC) surveillance after sustained virologic response (SVR) to HCV treatment allow early detection of operable HCC in Taiwan. However, the effects of achieving SVR on patient characteristics and surgical outcomes after curative resection remain elusive. We aimed to compare the clinical presentation and postoperative prognosis among patients with early-stage HCV-related HCC and different viral status. We retrospectively analyzed 208 patients with BCLC stage 0 or A-HCC, including 44 patients who remained HCV viremic, 90 patients who developed HCC after achieving SVR (post-SVR HCC), and 74 patients who subsequently achieved SVR after resection. Patients with post-SVR HCC had a lower degree of hepatitis and better liver function than those who achieved SVR or remained viremic after resection. Notably, 75.6% of patients with post-SVR HCC did not have cirrhosis. Patients with post-SVR HCC and those achieving SVR after resection exhibited comparable recurrence rates and recurrence-free survival, while patients with persistent viremia had the worst surgical outcomes. We concluded that patients with post-SVR HCC had a better liver function but similar surgical outcomes compared with patients who achieved SVR after resection. The low prevalence of cirrhosis in patients with post-SVR HCC highlights the importance of regular surveillance after SVR.

Keywords: chronic hepatitis C; hepatocellular carcinoma; recurrence; sustained virologic response; viremia.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Antiviral Agents / therapeutic use
Carcinoma, Hepatocellular* / drug therapy
Hepatitis C* / complications
Hepatitis C* / drug therapy
Humans
Liver Cirrhosis / drug therapy
Liver Neoplasms* / drug therapy
Retrospective Studies
Sustained Virologic Response
Viremia / drug therapy

Substances

Antiviral Agents

Grants and funding

This study was supported partially by grants from National Science Council of Taiwan (grant number MOST 109-2314-B-037-045-MY3 and 111-2314-B-037-102) and National Pingtung University of Science and Technology and Kaohsiung Medical University (NPUST kmU-111-P009).