De-novo versus recurrent hepatocellular carcinoma following direct-acting antiviral therapy for hepatitis C virus

Abstract

Although de-novo HCC lesions significantly developed later than recurrent lesions in DAAs-treated patients, their response rates were significantly better. No differences were detected between both groups in their response to DAAs and their tumoral characteristics.

Recurrence of hepatocellular carcinoma after direct acting antiviral treatment for hepatitis C virus infection: Literature review and risk analysis

“…Overall, 24 papers (with 25 cohorts of patients) [6,7, reporting on HCC recurrence after DAAs treatment in patients with previously and successfully treated HCC (liver resection, ablation or trans-catheter arterial chemoembolization -TACE) were identified. Two papers only considered patients with HCC recurrence [25,27], two included also patients who underwent liver transplantation before starting DAAs [16,29], and one focused on radiological features of…”

“…Some authors speculated about a major aggressiveness of the recurrent tumor in DAAs treated patients [6,10,11,[26][27][28]. However, it should be noted that a definition of HCC aggressiveness does not exist in literature, or at least an agreement on its definition has not been reached as yet.…”

“…Although most recurring tumor were diagnosed in BCLC stage 0 or A [6, 11, 16, 20, 22-24, 26, 29], the authors identified as signs of HCC aggressiveness the following factors: fast tumor growth with a low response rate to ablation [27], percentage of infiltrative [6,11] or multifocal [26] tumor pattern, and radiological signs of microvascular invasion (mVI) [28]. Specifically, Renzulli and coll.…”

“…In the study by Abdelaziz and coll. [27] chemoembolization was adopted in 51.1% of cases, whereas local ablation and resection were used in a minority of cases (8.9% and 4.4%, respectively). Disease control was achieved in about half of cases (51.1%), while in one third of patients (33.3%) only supportive treatment was possible.…”

Current and forthcoming perspectives in linkage to care of hepatitis C virus infection: Assessment of an Italian focus group

“…However, achieving SVR with DAAs does not seem to reduce the risk of HCC development [61]. De novo HCC lesions appear to develop significantly later than recurrent lesions in patients treated with DAAs, with response rates that are significantly lower in the latter subjects [62]. Moreover, a casecontrol study on patients with HCV-related HCC reported that HCC behaviour was more aggressive in DAA-treated patients than in non-DAA patients in terms of portal vein thrombosis, malignant lymphadenopathy and HCC imaging characteristics [63].…”