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Direct-Acting Antivirals Improve Treatment Outcomes in Patients with Hepatitis C Virus-Related Hepatocellular Carcinoma Treated with Transarterial Chemoembolization: A Nationwide, Multi-center, Retrospective Cohort Study

 Hye Kyung Hyun  ;  Eun Ju Cho  ;  Soo Young Park  ;  Young Mi Hong  ;  Soon Sun Kim  ;  Hwi Young Kim  ;  Nae-Yun Heo  ;  Jung Gil Park  ;  Dong Hyun Sinn  ;  Wonseok Kang  ;  Song Won Jeong  ;  Myeong Jun Song  ;  Hana Park  ;  Danbi Lee  ;  Yong Sun Lee  ;  Sung Bum Cho  ;  Chan Sik An  ;  Hyung Jin Rhee  ;  Hyun Woong Lee  ;  Beom Kyung Kim  ;  Jun Yong Park  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Kwang-Hyub Han  ;  Jeong-Hoon Lee  ;  Su Jong Yu  ;  Yoon Jun Kim  ;  Jung-Hwan Yoon  ;  Won Young Tak  ;  Young Oh Kweon  ;  Ki Tae Yoon  ;  Mong Cho  ;  Jae Youn Cheong  ;  Seung Ha Park  ;  Seung Up Kim 
 DIGESTIVE DISEASES AND SCIENCES, Vol.66(7) : 2427-2438, 2021-07 
Journal Title
Issue Date
Direct-acting antiviral ; Hepatitis C virus ; Hepatocellular carcinoma ; Progression ; Transarterial chemoembolization
Background and aims: The influence of direct-acting antivirals (DAAs) on chronic hepatitis C (CHC)-related hepatocellular carcinoma (HCC) remains controversial. We investigated the effect of eradicating CHC using DAAs on treatment outcomes in patients with CHC-related HCC treated with transarterial chemoembolization (TACE).

Methods: This nationwide, multi-center, retrospective study recruited patients with CHC-related HCC treated with TACE as the first-line anti-cancer treatment, and who achieved a sustained virological response (SVR) using DAAs (DAA group) between 2006 and 2017. Patients achieving an SVR following interferon-based treatment (IFN group) and those without treatment (control group) were also recruited for comparison.

Results: A total of 425 patients were eligible for the study. Of these, 356 (83.8%), 26 (6.1%), and 43 (10.1%) were allocated to the control, IFN, and DAA groups, respectively. A multivariate analysis showed that liver cirrhosis, segmental portal vein thrombosis, and larger maximal tumor size independently predicted an increased risk of progression (all p < 0.05), whereas, the DAA group (vs. IFN and control groups) independently predicted a reduced risk of progression (hazard ratio (HR) = 0.630, 95% confidence interval 0.411-0.966, p = 0.034). The cumulative incidence rate of HCC progression in the DAA group was significantly lower than that in the IFN and control groups (p = 0.033, log-rank test). In addition, the DAA group (vs. IFN and control groups) was independently associated with a reduced risk of mortality (p = 0.042).

Conclusions: DAA treatment provided significantly prolonged progression-free survival in patients with CHC-related HCC treated with TACE compared to that in patients administered IFN or no treatment.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Hyun Woong(이현웅) ORCID logo https://orcid.org/0000-0002-6958-3035
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
Hyun, Hye Kyung(현혜경)
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