Backgrounds: Direct-acting antiviral (DAA) therapy, which achieves a high sustained virological response (SVR) rate, has been established as a standard treatment for patients with hepatitis C virus (HCV) infection. However, the risk factors for postoperative recurrence in patients with HCV-related hepatocellular carcinoma (HCC) detected after the achievement of an SVR by DAAs are unknown.Methods: The clinical records of 95 patients with initial HCV-related HCC detected after DAA-SVR achievement, who underwent liver resection between September 2014 and December 2020, were retrospectively reviewed. Patients with major vascular invasion and/or SVR achievement induced by interferon-based therapy were excluded. In this study, the patients were divided into two groups according to their alcohol intake status: without alcohol abuse (<80 g of ethanol each day for at least 5 years, n = 85) and with (continuous) alcohol abuse (n = 10). The risk factors for recurrence after liver resection were investigated, with special reference to the alcohol intake status.Results: The 3- and 5-year disease-free survival (DFS) rates after liver resection were 68.7% and 55.3%, respectively. Univariate and multivariate analyses identified alcohol abuse [hazard ratio (HR) 3.36,p= 0.004] and tumor size (HR 2.53,p= 0.010) as independent risk factors for postoperative recurrence. The 3- and 5-year postoperative DFS rates were 72.2% and 61.5% for patients without alcohol abuse and 40.0% and 13.3% for those with alcohol abuse (p= 0.001).Conclusions: Continuous alcohol abuse is a risk factor for recurrence after surgery of HCC detected after the achievement of DAA-SVR.
背景：直接抗病毒药物（DAA）治疗可实现较高的持续病毒学应答率，现已成为丙型肝炎病毒（HCV）感染患者的标准治疗方案。然而，对于在DAA治疗后获得SVR后发现的HCV相关肝细胞癌（HCC）患者，其术后复发的危险因素尚不明确。 方法：本研究回顾性分析了2014年9月至2020年12月期间接受肝切除术的95例在DAA治疗后获得SVR后首次发现HCV相关HCC患者的临床资料。排除了存在主要血管侵犯和/或通过干扰素治疗获得SVR的患者。根据饮酒状况将患者分为两组：无酒精滥用组（每日乙醇摄入量<80克且持续至少5年，n=85）和持续酒精滥用组（n=10）。本研究重点探讨了饮酒状况对肝切除术后复发风险的影响。 结果：肝切除术后3年和5年无病生存率分别为68.7%和55.3%。单因素和多因素分析均显示，酒精滥用[风险比（HR）3.36，p=0.004]和肿瘤大小（HR 2.53，p=0.010）是术后复发的独立危险因素。无酒精滥用患者的术后3年和5年无病生存率分别为72.2%和61.5%，而酒精滥用患者分别为40.0%和13.3%（p=0.001）。 结论：持续酒精滥用是DAA治疗后获得SVR后发现的HCC患者术后复发的危险因素。
肿瘤(癌症)患者之家