Recurrence of hepatocellular carcinoma after direct acting antiviral treatment for hepatitis C virus infection

Literature review and risk analysis

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, Maria Guarino, Luca Viganò, Francesca Romana Ponziani, Edoardo Giovanni Giannini, Quirino Lai, Filomena Morisco, Alessandro Vitale, Russo Francesco Paolo, Umberto Cillo, Patrizia Burra, Claudia Mescoli, Martina Gambato, Anna Sessa, Cabibbo Giuseppe, Viganò Mauro, Galati Giovanni, Erica Villa, Iavarone Massimo, Brancaccio Giuseppina & 31 others Maria Rendina, Luigi G. Lupo, Francesco Losito, Fabio Fucilli, Marcello Persico, Roberta D'Ambrosio, Angelo Sangiovanni, Alessandro Cucchetti, Franco Trevisani e Matteo Renzulli, Luca Miele, Antonio Grieco, Gian Lodovico Rapaccini, Maurizio Pompili, Antonio Gasbarrini, Giovanni Battisa Levi Sandri, Fabio Melandro, Massimo Rossi, Ilaria Lenci, Tommaso Maria Manzia, Raffaella Tortora, Giovan Giuseppe Di Costanzo, Sacco Rodolfo, Davide Ghinolfi, Erion Rreka, Paola Carrai, Natalia Simonetti, Carlo Sposito, Sherrie Bhoori, Stefano di Sandro, Francesco Giuseppe Foschi, Andrea Casadei Gardini

Research output: Contribution to journalArticle

Abstract

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.
Original languageEnglish
Pages (from-to)1105-1114
Number of pages10
JournalDigestive and Liver Disease
Volume50
Issue number11
DOIs
Publication statusPublished - 2018

Fingerprint

Virus Diseases
Hepacivirus
Antiviral Agents
Hepatocellular Carcinoma
Recurrence
Therapeutics
Intention to Treat Analysis
Blood Vessels
Neoplasms
Fibrosis
Growth
Research

Keywords

  • DAA
  • HCC
  • HCV
  • Recurrence

Cite this

Recurrence of hepatocellular carcinoma after direct acting antiviral treatment for hepatitis C virus infection : Literature review and risk analysis. / Liver, On behalf of the Special Interest Group on Hepatocellular carcinoma and new anti-HCV therapies” of the Italian Association for the Study of the; Guarino, Maria; Viganò, Luca; Ponziani, Francesca Romana; Giannini, Edoardo Giovanni; Lai, Quirino; Morisco, Filomena; Vitale, Alessandro; Francesco Paolo, Russo; Cillo, Umberto; Burra, Patrizia; Mescoli, Claudia; Gambato, Martina; Sessa, Anna; Giuseppe, Cabibbo; Mauro, Viganò; Giovanni, Galati; Villa, Erica; Massimo, Iavarone; Giuseppina, Brancaccio; Rendina, Maria; Lupo, Luigi G.; Losito, Francesco; Fucilli, Fabio; Persico, Marcello; D'Ambrosio, Roberta; Sangiovanni, Angelo; Cucchetti, Alessandro; Trevisani e Matteo Renzulli, Franco; Miele, Luca; Grieco, Antonio; Lodovico Rapaccini, Gian; Pompili, Maurizio; Gasbarrini, Antonio; Battisa Levi Sandri, Giovanni; Melandro, Fabio; Rossi, Massimo; Lenci, Ilaria; Maria Manzia, Tommaso; Tortora, Raffaella; Di Costanzo, Giovan Giuseppe; Rodolfo, Sacco; Ghinolfi, Davide; Rreka, Erion; Carrai, Paola; Simonetti, Natalia; Sposito, Carlo; Bhoori, Sherrie; di Sandro, Stefano; Foschi, Francesco Giuseppe; Casadei Gardini, Andrea.

In: Digestive and Liver Disease, Vol. 50, No. 11, 2018, p. 1105-1114.

Research output: Contribution to journalArticle

Liver, OBOTSIGOHCANA-HCVTOTIAFTSOT, Guarino, M, Viganò, L, Ponziani, FR, Giannini, EG, Lai, Q, Morisco, F, Vitale, A, Francesco Paolo, R, Cillo, U, Burra, P, Mescoli, C, Gambato, M, Sessa, A, Giuseppe, C, Mauro, V, Giovanni, G, Villa, E, Massimo, I, Giuseppina, B, Rendina, M, Lupo, LG, Losito, F, Fucilli, F, Persico, M, D'Ambrosio, R, Sangiovanni, A, Cucchetti, A, Trevisani e Matteo Renzulli, F, Miele, L, Grieco, A, Lodovico Rapaccini, G, Pompili, M, Gasbarrini, A, Battisa Levi Sandri, G, Melandro, F, Rossi, M, Lenci, I, Maria Manzia, T, Tortora, R, Di Costanzo, GG, Rodolfo, S, Ghinolfi, D, Rreka, E, Carrai, P, Simonetti, N, Sposito, C, Bhoori, S, di Sandro, S, Foschi, FG & Casadei Gardini, A 2018, 'Recurrence of hepatocellular carcinoma after direct acting antiviral treatment for hepatitis C virus infection: Literature review and risk analysis', Digestive and Liver Disease, vol. 50, no. 11, pp. 1105-1114. https://doi.org/10.1016/j.dld.2018.08.001
Liver, On behalf of the Special Interest Group on Hepatocellular carcinoma and new anti-HCV therapies” of the Italian Association for the Study of the ; Guarino, Maria ; Viganò, Luca ; Ponziani, Francesca Romana ; Giannini, Edoardo Giovanni ; Lai, Quirino ; Morisco, Filomena ; Vitale, Alessandro ; Francesco Paolo, Russo ; Cillo, Umberto ; Burra, Patrizia ; Mescoli, Claudia ; Gambato, Martina ; Sessa, Anna ; Giuseppe, Cabibbo ; Mauro, Viganò ; Giovanni, Galati ; Villa, Erica ; Massimo, Iavarone ; Giuseppina, Brancaccio ; Rendina, Maria ; Lupo, Luigi G. ; Losito, Francesco ; Fucilli, Fabio ; Persico, Marcello ; D'Ambrosio, Roberta ; Sangiovanni, Angelo ; Cucchetti, Alessandro ; Trevisani e Matteo Renzulli, Franco ; Miele, Luca ; Grieco, Antonio ; Lodovico Rapaccini, Gian ; Pompili, Maurizio ; Gasbarrini, Antonio ; Battisa Levi Sandri, Giovanni ; Melandro, Fabio ; Rossi, Massimo ; Lenci, Ilaria ; Maria Manzia, Tommaso ; Tortora, Raffaella ; Di Costanzo, Giovan Giuseppe ; Rodolfo, Sacco ; Ghinolfi, Davide ; Rreka, Erion ; Carrai, Paola ; Simonetti, Natalia ; Sposito, Carlo ; Bhoori, Sherrie ; di Sandro, Stefano ; Foschi, Francesco Giuseppe ; Casadei Gardini, Andrea. / Recurrence of hepatocellular carcinoma after direct acting antiviral treatment for hepatitis C virus infection : Literature review and risk analysis. In: Digestive and Liver Disease. 2018 ; Vol. 50, No. 11. pp. 1105-1114.
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T2 - Literature review and risk analysis

AU - Liver, On behalf of the Special Interest Group on Hepatocellular carcinoma and new anti-HCV therapies” of the Italian Association for the Study of the

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

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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

U2 - 10.1016/j.dld.2018.08.001

DO - 10.1016/j.dld.2018.08.001

M3 - Article

VL - 50

SP - 1105

EP - 1114

JO - Digestive and Liver Disease

JF - Digestive and Liver Disease

SN - 1590-8658

IS - 11

ER -