TY - JOUR
T1 - Recurrence of hepatocellular carcinoma after direct acting antiviral treatment for hepatitis C virus infection
T2 - Literature review and risk analysis
AU - On behalf of the Special Interest Group on Hepatocellular carcinoma and new anti-HCV therapies” of the Italian Association for the Study of the Liver
AU - Guarino, Maria
AU - Viganò, Luca
AU - Ponziani, Francesca Romana
AU - Giannini, Edoardo Giovanni
AU - Lai, Quirino
AU - Morisco, Filomena
AU - Vitale, Alessandro
AU - Francesco Paolo, Russo
AU - Cillo, Umberto
AU - Burra, Patrizia
AU - Mescoli, Claudia
AU - Gambato, Martina
AU - Sessa, Anna
AU - Giuseppe, Cabibbo
AU - Mauro, Viganò
AU - Giovanni, Galati
AU - Villa, Erica
AU - Massimo, Iavarone
AU - Giuseppina, Brancaccio
AU - Rendina, Maria
AU - Lupo, Luigi G.
AU - Losito, Francesco
AU - Fucilli, Fabio
AU - Persico, Marcello
AU - D'Ambrosio, Roberta
AU - Sangiovanni, Angelo
AU - Cucchetti, Alessandro
AU - Trevisani e Matteo Renzulli, Franco
AU - Miele, Luca
AU - Grieco, Antonio
AU - Lodovico Rapaccini, Gian
AU - Pompili, Maurizio
AU - Gasbarrini, Antonio
AU - Battisa Levi Sandri, Giovanni
AU - Melandro, Fabio
AU - Rossi, Massimo
AU - Lenci, Ilaria
AU - Maria Manzia, Tommaso
AU - Tortora, Raffaella
AU - Di Costanzo, Giovan Giuseppe
AU - Rodolfo, Sacco
AU - Ghinolfi, Davide
AU - Rreka, Erion
AU - Carrai, Paola
AU - Simonetti, Natalia
AU - Sposito, Carlo
AU - Bhoori, Sherrie
AU - di Sandro, Stefano
AU - Foschi, Francesco Giuseppe
AU - Casadei Gardini, Andrea
PY - 2018
Y1 - 2018
N2 - Although studies suggest decreased incident hepatocellular carcinoma (HCC) after treatment with direct-acting antivirals (DAAs) for hepatitis C virus (HCV) infection, data are conflicting regarding risk and aggressiveness of recurrence in patients who have a history of treated HCC. This review analyses data available in literature in order to elucidate the impact of DAAs on the risk of HCC recurrence after successful treatment of the tumor. Overall 24 papers were identified. The available data cannot be considered definitive, but the initial alarmist data indicating an increased risk of recurrence have not been confirmed by most subsequent studies. The suggested aggressive pattern (rapid growth and vascular invasion) of tumor recurrence after DAAs still remains to be confirmed. Several limitations of the available studies were highlighted, and should drive future researches. The time-to-recurrence should be computed since the last HCC treatment and results stratified for cirrhosis and sustained viral response. Any comparison with historical series is of limited interest because of a number of biases affecting these studies and differences between enrolled patients. Prospective intention-to-treat analyses will be probably the best contribution to drive clinical practice, provided that a randomized trial can be difficult to design.
AB - Although studies suggest decreased incident hepatocellular carcinoma (HCC) after treatment with direct-acting antivirals (DAAs) for hepatitis C virus (HCV) infection, data are conflicting regarding risk and aggressiveness of recurrence in patients who have a history of treated HCC. This review analyses data available in literature in order to elucidate the impact of DAAs on the risk of HCC recurrence after successful treatment of the tumor. Overall 24 papers were identified. The available data cannot be considered definitive, but the initial alarmist data indicating an increased risk of recurrence have not been confirmed by most subsequent studies. The suggested aggressive pattern (rapid growth and vascular invasion) of tumor recurrence after DAAs still remains to be confirmed. Several limitations of the available studies were highlighted, and should drive future researches. The time-to-recurrence should be computed since the last HCC treatment and results stratified for cirrhosis and sustained viral response. Any comparison with historical series is of limited interest because of a number of biases affecting these studies and differences between enrolled patients. Prospective intention-to-treat analyses will be probably the best contribution to drive clinical practice, provided that a randomized trial can be difficult to design.
KW - DAA
KW - HCC
KW - HCV
KW - Recurrence
UR - http://www.scopus.com/inward/record.url?scp=85052759999&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85052759999&partnerID=8YFLogxK
U2 - 10.1016/j.dld.2018.08.001
DO - 10.1016/j.dld.2018.08.001
M3 - Article
AN - SCOPUS:85052759999
VL - 50
SP - 1105
EP - 1114
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
SN - 1590-8658
IS - 11
ER -