A meta-analysis of single HCV-untreated arm of studies evaluating outcomes after curative treatments of HCV-related hepatocellular carcinoma

Giuseppe Cabibbo, Salvatore Petta, Marco Barbàra, Gabriele Missale, Roberto Virdone, Eugenio Caturelli, Fabio Piscaglia, Filomena Morisco, Antonio Colecchia, Fabio Farinati, Edoardo Giannini, Franco Trevisani, Antonio Craxì, Massimo Colombo, Calogero Cammà, Laura Bucci, Marco Zoli, Francesca Garuti, Barbara Lenzi, Maurizio BiselliPaolo Caraceni, Alessandro Cucchetti, Annagiulia Gramenzi, Alessandro Granito, Donatella Magalotti, Carla Serra, Giulia Negrini, Lucia Napoli, Veronica Salvatore, Francesca Benevento, Luisa Benvegnù, Alessia Gazzola, Francesca Murer, Caterina Pozzan, Veronica Vanin, Alessandro Moscatelli, Gaia Pellegatta, Antonino Picciotto, Vincenzo Savarino, Francesca Ciccarese, Paolo Del Poggio, Stefano Olmi, Nicoletta de Matthaeis, Mariella Di Marco Claudia Balsamo, Elena Vavassori, Paola Roselli, Serena Dell’Isola, Anna Maria Ialungo, Elena Rastrelli, Francesco Giuseppe Foschi, the ITA.LI.CA study group

Research output: Contribution to journalArticle

Abstract

Background & Aims: Determining risk for recurrence or survival after curative resection or ablation in patients with hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) is important for stratifying patients according to expected outcomes in future studies of adjuvant therapy in the era of direct-acting antivirals (DAAs). The aims of this meta-analysis were to estimate the recurrence and survival probabilities of HCV-related early HCC following complete response after potentially curative treatment and to identify predictors of recurrence and survival. Methods: Studies reporting time-dependent outcomes (HCC recurrence or death) after potentially curative treatment of HCV-related early HCC were identified in MEDLINE through May 2016. Data on patient populations and outcomes were extracted from each study by three independent observers and combined using a distribution-free summary survival curve. Primary outcomes were actuarial probabilities of recurrence and survival. Results: Eleven studies met the inclusion criteria. Pooled estimates of actuarial recurrence rates were 7.4% at 6 months and 47.0% at 2 years. Pooled estimates of actuarial survival rates were 79.8% at 3 years and 58.6% at 5 years. Heterogeneity among studies was highly significant for all outcomes. By univariate meta-regression analyses, lower serum albumin, randomized controlled trial study design and follow-up were independently associated with higher recurrence risk, whereas tumour size and alpha-foetoprotein levels were associated with higher mortality. Conclusions: This meta-analysis showed that recurrence risk and survival are extremely variable in patients with successfully treated HCV-related HCC, providing a useful benchmark for indirect comparisons of the benefits of DAAs and for a correct design of randomized controlled trials in the adjuvant setting.

Original languageEnglish
Pages (from-to)1157-1166
Number of pages10
JournalLiver International
Volume37
Issue number8
DOIs
Publication statusPublished - Aug 1 2017

Keywords

  • hepatocellular carcinoma
  • prognosis
  • recurrences
  • survival

ASJC Scopus subject areas

  • Hepatology

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    Cabibbo, G., Petta, S., Barbàra, M., Missale, G., Virdone, R., Caturelli, E., Piscaglia, F., Morisco, F., Colecchia, A., Farinati, F., Giannini, E., Trevisani, F., Craxì, A., Colombo, M., Cammà, C., Bucci, L., Zoli, M., Garuti, F., Lenzi, B., ... the ITA.LI.CA study group (2017). A meta-analysis of single HCV-untreated arm of studies evaluating outcomes after curative treatments of HCV-related hepatocellular carcinoma. Liver International, 37(8), 1157-1166. https://doi.org/10.1111/liv.13357