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

Antonio Craxi, Margherita Rossi, Calogero Camma', Salvatore Petta, Giuseppe Cabibbo, Salvatore Petta, Alberto Masotto, Matteo Renzulli, Massimo Colombo, Andrea Olivani, Nicoletta De Matthaeis, Paola Roselli, Alberta Cappelli, Giuseppe Cabibbo, Anna Maria Ialungo, Emanuele Rinninella, Veronica Salvatore, Elena Rastrelli, Andrea Affronti, Veronica VaninCristina Mosconi, Alessandro Moscatelli, Alessia Gazzola, Barbara Lenzi, Fabio Marra, Antonio Gasbarrini, Caterina Pozzan, Lucia Napoli, Simona Attardo, Andrea L Inghilesi, Valeria Mismas, Francesca Ciccarese, Rita Golfieri, Maria Guarino, Francesca Murer, Arianna Lanzi, Marco Barbàra, Annagiulia Gramenzi, Fabiana Marchetti, Andrea Costantino, Giulia Negrini, Antonio Gasbarrini, Gaia Pellegatta, Matteo Valerio, Elga Neri, Elena Vavassori, Elisabetta Biasini, Sami Aburas, Marco Sanduzzi Zamparelli, Serena Dell’Isola, Anna Chiara Dall’Aglio, Andrea Mega, Alessio Ortolani, Marta Mascari, Marco Affronti, Marco Zoli, Valentina Feletti, Maurizio Pompili, Margherita Rossi, Mariella Di Marco Claudia Balsamo, Gialuca Svegliati-Baroni, Francesca Garuti, Francesco Giuseppe Foschi, Laura Bucci, Donatella Magalotti, Stefano Olmi, Piero Coccoli, Alessandro Granito, Francesca Benevento, Stefano Tamberi, Piero Coccoli, Alessandro Granito, Alessandro Cucchetti, Roberto Virdone, Paolo Del Poggio, Maurizio Biselli, Luisa Benvegnù, Filomena Morisco, Antonio Colecchia, Gerardo Nardone, Paolo Caraceni, Fabio Piscaglia, Calogero Cammà, Martina Felder, Fabio Farinati, Franco Trevisani, Gabriele Missale, Antonio Craxì, Eugenio Caturelli, Antonino Picciotto, Rodolfo Sacco, Edoardo Giannini, Vincenzo Savarino, Carla Serra, Giuseppe Francesco Stefanini, Federica Mirici Cappa, Andrea Affronti, Andrea Costantino, Marco Affronti, Marco Barbara, Simona Attardo

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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
Publication statusPublished - 2017

All Science Journal Classification (ASJC) codes

  • Hepatology

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    Craxi, A., Rossi, M., Camma', C., Petta, S., Cabibbo, G., Petta, S., Masotto, A., Renzulli, M., Colombo, M., Olivani, A., De Matthaeis, N., Roselli, P., Cappelli, A., Cabibbo, G., Ialungo, A. M., Rinninella, E., Salvatore, V., Rastrelli, E., Affronti, A., ... Attardo, S. (2017). A meta-analysis of single HCV-untreated arm of studies evaluating outcomes after curative treatments of HCV-related hepatocellular carcinoma. Liver International, 37, 1157-1166.