Predictors of hepatocellular carcinoma in HCV cirrhotic patients treated with direct acting antivirals.

Vincenza Calvaruso, Vito Di Marco, Alessio Aghemo, Ana Lleo, Massimo Colombo, Alessia M. Giorgini, Pietro Andreone, Maurizia R. Brunetto, Fabio Conti, Vincenzo Boccaccio, Elisabetta Degasperi, Luca Marzi, Erica Villa, Giulia Troshina, Massimo Zuin, Alfredo Di Leo, Andrea Aglitti, Marcello Persico, Barbara Coco, Maria RendinaSimona Bollani, Alessia Ciancio, Patrick Maisonneuve, Pietro Lampertico, Marcello Persico, Savino Bruno

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19 Citations (Scopus)

Abstract

Background: Despite the dramatic improvement in viral eradication rates that has been reached withdirect antiviral agents (DAAs),the real benefit of viral eradication after DAAs on hepatocellular carcinoma(HCC) development is still controversial.Aim: To prospectively assess the risk of HCC occurrence and early recurrence in a large cohort of DAAtreated HCV-cirrhotic patients and to identify potential predictors of HCC development.Methods: We analyzed data prospectively collected from 1927 consecutive HCV-infected cirrhoticpatients treated with DAA from January to December 2015 in 10 tertiary liver centers in Italy andfollowed-up for one year after therapy. 161 patients had a previous HCC.Results: 38/161 subjects developed tumor recurrence during the follow-up (recurrence rate = 24.8 per100-year), patients with SVR had a significantly lower rate of recurrence. Lack of SVR and alphafetoprotein (AFP) were independent predictors of HCC recurrence. 50/1766 patients without a previousHCC history developed HCC during follow-up (incidence rate = 2.4 per 100-year). Lack of SVR was thestrongest predictor of HCC development. Furthermore, patients with SVR and no stigmata of portalhypertension have a lower incidence rate of HCC (1.0 per 100-year).Conclusions: SVR is associated with a significant decrease of recurrent or de novo HCC. Baseline AFP andsigns of portal hypertension can help to stratify the risk of HCC.© 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved
Original languageEnglish
Pages (from-to)310-317
Number of pages8
JournalDigestive and Liver Disease
Volume51
Publication statusPublished - 2018

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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