De novo hepatocellular carcinoma in cirrhotic hepatitis C virus: Are directly acting antivirals beneficial?

Montasser, Iman Fawzy; Ibrahim, Amany; Farid, Hoda M.; Balakosy, Amira Mahmoud Al

doi:10.1016/j.clinre.2020.07.022

Cited by 1 publication

(2 citation statements)

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“…SVR patients thus received more frequent curative treatment for recurrence (Toyoda et al, 2021). Montasser (2021) reported that tumor size in DAA-treated patients was statistically larger than in patients without a history of such treatment (p = 0.03), but types of intervention, BCLC stage, and survival had no impact (Montasser et al, 2021). The incidence of HCC after DAA administration and its biological behavior is also expected to impact survival.…”

Section: Discussionmentioning

confidence: 99%

“…Conversely, other studies found a higher survival rate in SVR achievers who developed de-novo HCC lesions during surveillance, despite similar recurrence rates after curative HCC management (Toyoda et al, 2021). Tumors were more extensive in patients that received DAA treatment, but no difference in survival was reported in another study (Montasser et al, 2021). Thus, conflicting results dominate studies related to the de-novo incidence of HCC in DAA-treated patients.…”

Section: Introductionmentioning

confidence: 97%

See 1 more Smart Citation

Prospective Comparison of Hepatocellular Carcinoma Behavior and Survival of Patients who Did or Did not Receive HCV Direct-Acting Antivirals

Kassas

Sayed

Omran

et al. 2023

Asian Pac J Cancer Prev

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Background & Aims: The safety and efficacy of hepatitis C (HCV) direct-acting antivirals (DAAs) have been established in several real-world trials; however, some reports have claimed an association between DAAs and hepatocellular carcinoma (HCC) occurrence or aggressive behavior. We aimed to prospectively examine differences in de-novo HCC tumor behavior and overall survival (OS) in DAAs-treated versus HCV-untreated patients as measured by BCLC progression during a two-year follow-up period. Methods: This multicenter cohort study recruited 523 patients with de-novo HCV-related HCC. After exclusion criteria were applied, 353 patients were placed into; Group 1, including 236 patients without a history of DAAs therapy, and Group 2 including 117 patients with de-novo HCC developed after receiving DAAs. Patients were then stratified in each group according to BCLC staging (Liver, 2018). All patients received standard of care management and were followed until death or a maximum of 2 years. Results: No statistically significant differences were observed between the two groups regarding tumor characteristics (number and size of lesions) and criteria for aggressiveness upon presentation. Among all BCLC stages, DAAs treated patients showed significantly lower baseline Fib4 values than DAA untreated patients in BCLC-0 stage (4.1 vs 7.7, p 0.019). No statistically significant differences were evident in HCC progression in the different BCLC stages at 12 and 24 months follow up periods (p 0.0718 and 0.279 respectively). Significantly better survival was recorded in Group 1 compared to Group 2 patients for BCLC stages C and D (p = 0.003 and 0.01, respectively). Conclusion: HCC may develop at an earlier stage of liver disease after DAAs therapy. No defensive role was found for DAAs treatment in delaying HCC progression that occurs after viral eradication.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%