Comments by Alan
Franciscus, Editor-in-Chief, HCV Advocate:
carcinoma (HCC [liver cancer]), if diagnosed in time, can be treated by
surgical removal of the portion of the liver with the tumor(s)—this is called a
liver resection. The goal of the surgery
is to completely remove any tumors or cancer.
The 5-year survival rate for a person who has the surgery is about 30 to
40%. Frequently, other therapies are
used after the resection to suppress any new tumors. If the liver cancer returns there are
additional therapies available to treat it, but if the liver decompensates a
liver transplantation is one of the few options—that is as long as the liver
cancer has not spread to any other organs.
One therapy after a resection is to treat with pegylated interferon plus
below analyzed the patient database of those who received a liver resection. There were 213 patients who were treated with
PEG/RBV for at least 16 weeks after the resection. The comparator group was composed of 213 patients
who received the liver resection surgery, but who did not receive PEG/RBV therapy.
that after 5 years of follow-up 52.1%
of the patients who received PEG/RBV had a recurrence of liver cancer compared
to 63.9% of the group who did
not receive PEG/RBV. It was found that
several factors—age, cirrhosis, and type 2 diabetes—negatively influenced the
recurrence of liver cancer even with post-surgery PEG/RBV treatment.
2013 Feb 6. doi: 10.1002/hep.26300. [Epub ahead of print]
peg-interferon plus ribavirin associated with reduced recurrence of hepatitis C
virus-related hepatocellular carcinoma.
Institute of Clinical Medicine, China Medical University, Taichung; Department
of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung.
Hepatocellular carcinoma (HCC) frequently recurs after surgical
This population-based research aimed to investigate the association
between postoperative antiviral treatment and risk of recurrent HCC in patients
with hepatitis C virus (HCV) infection.
By analyzing the Taiwan National
Health Insurance Research Database, we initially screened a total of 100,938
patients diagnosed with HCC for the first time between October 2003 and December
2010. Among 2,237 antiviral-naïve HCV-infected patients who curatively resected
HCC, there were 213 patients receiving antiviral treatment with pegylated
interferon plus ribavirin for 16 weeks or more after surgery (treated cohort).
These treated patients were matched 1:4 with 852 controls who never treated HCV
infection (untreated cohort), in age, gender, cirrhosis, and the elapsed time
between surgery and antiviral therapy. Cumulative incidences of and hazard
ratios for recurrent HCC were calculated after adjusting for competing
The recurrence rate of HCC was significantly lower in the treated than
untreated cohort, with 52.1% (95% confidence interval [CI], 42.0-62.2%) and 63.9% (95% CI, 58.9-68.8%) after 5
years of follow-up, respectively (p=0.001). The number needed to treat for one
fewer recurrent HCC at 5 years was 8. The association between postoperative
antiviral treatment and risk of recurrent HCC was independent to adjustment for
multiple covariates, with an adjusted hazard ratio of 0.64 (95% CI, 0.50-0.83).
Stratified analyses revealed that the attenuation in recurrence risk was
greater in patients younger than 60 years and those without cirrhosis or
plus ribavirin is associated with reduced recurrence of HCC in patients with
HCV infection. Age, liver cirrhosis, and diabetes mellitus appear to modify
this association. (HEPATOLOGY 2013.).
© 2013 American Association for the Study of Liver Diseases.