Eradication of hepatitis C virus profoundly prolongs survival in hepatocellular carcinoma patients receiving transarterial chemoembolization

被引:10
|
作者
Teng, W. [1 ,3 ,4 ]
Hsieh, Y. -C. [1 ,4 ]
Lui, K. -W. [2 ,4 ]
Chen, W. -T. [1 ,4 ]
Hung, C. -F. [2 ,4 ]
Huang, C. -H. [1 ,4 ]
Chen, Y. -C. [1 ,4 ]
Jeng, W. -J. [1 ,3 ,4 ,5 ]
Lin, C. -C. [1 ,4 ]
Lin, C. -Y. [1 ,4 ]
Lin, S. -M. [1 ,4 ,5 ]
Sheen, I. -S. [1 ,4 ]
机构
[1] Chang Gung Mem Hosp, Linkou Med Ctr, Dept Gastroenterol & Hepatol, Taoyuan, Taiwan
[2] Chang Gung Mem Hosp, Linkou Med Ctr, Dept Radiol, Taoyuan, Taiwan
[3] Natl Yang Ming Univ, Inst Clin Med, Taipei, Taiwan
[4] Chang Gung Univ, Coll Med, Gueishan, Taiwan
[5] Chang Gung Univ, Sch Tradit Chinese Med, Coll Med, Gueishan, Taiwan
关键词
chronic hepatitis C; hepatocellular carcinoma; recurrence-free interval; survival; sustained virologic response; GROWTH-FACTOR RECEPTOR; DIABETES-MELLITUS; INTERFERON; RECURRENCE; THERAPY; RISK; MECHANISM; RIBAVIRIN; CIRRHOSIS; PREDICT;
D O I
10.1111/jvh.12745
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Adjuvant pegylated interferon plus ribavirin treatment (PegIFN/RBV) reduces recurrence and prolongs survival in early stage hepatocellular carcinoma (HCC) patients with chronic hepatitis C (CHC) infection receiving resection or ablation. However, the impact of antiviral therapy in intermediate and advanced stage of CHC-HCC patients is uncertain. This study aimed to investigate the impact PegIFN/RBV treatment on recurrence-free interval and survival in patients with HCC receiving transarterial chemoembolization (TACE). From 2010 to 2013, 274 CHC patients from a 1073 patient-based cohort composed of freshly diagnosed HCC and receiving TACE treatment the Chang Gung Memorial Hospital, Linkou Medical Center were recruited. Propensity score matching (PSM) (age, gender, AST to Platelet Ratio Index (APRI), tumour size, tumour number and Child-Turcotte-Pugh score) with the ratio 1:2 for patients with and without PegIFN/RBV treatment was performed. Statistics were performed with SPSS V.20 (IBM, USA). After matching, 153 patients were analysed and 27 patients (17.6%) achieved sustained virologic response (SVR). The 2-year cumulative overall survival rate and recurrence-free survival rate among patients with SVR, non-SVR, and untreated were 85.2% vs 58.3% vs 69.6% (P=.001) and 73.3% vs 53.8% vs 58.5% (P=.013). By Cox regression analysis, non-SVR, untreated, increase CTP score and nonresponder to TACE were independent factors related to mortality. The SVR achieved by PegIFN/RBV treatment markedly improves survival and reduces tumour recurrence in CHC-HCC patients receiving TACE treatment after complete response.
引用
收藏
页码:1160 / 1167
页数:8
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