Long-term evolution of LI-RADS observations in HCV-related cirrhosis treated with direct-acting antivirals

Vincenza Calvaruso, Federica Vernuccio, Salvatore Battaglia, Vito Di Marco, Roberto Cannella, Calogero Camma', Giuseppe Brancatelli, Massimo Midiri, Ciro Celsa, Federica Vernuccio, An Tang, Kingshuk Roy Choudhury, Silvia Greco, Roberto Cannella, Giuseppe Brancatelli, Massimo Midiri, Silvia Greco

Risultato della ricerca: Articlepeer review

Abstract

Background & AimsThe risk of progression of indeterminate observations to hepatocellular carcinoma (HCC) after direct-acting antivirals (DAA) is still undetermined. To assess whether DAA therapy changes the risk of progression of observations with low (LR-2), intermediate (LR-3) and high (LR-4) probability for HCC in cirrhotic patients and to identify predictors of progression.MethodsThis retrospective study included cirrhotic patients treated with DAA who achieved sustained virological response between 2015 and 2019. A total of 68 patients had pre-DAA indeterminate observations and at least six months CT/MRI follow-up before and after DAA. Two radiologists reviewed CT/MRI studies to categorize observations according to the LI-RADSv2018 and assess the evolution on subsequent follow-ups. Predictors of evolutions were evaluated by using the Cox proportional hazard model, Kaplan-Meier method and log-rank test.ResultsA total of 109 untreated observations were evaluated, including 31 (28.4%) LR-2, 67 (61.5%) LR-3 and 11 (10.1%) LR-4. During a median follow-up of 41 months, 17.4% and 13.3% of observations evolved to LR-5 or LR-M and LR-5, before and after DAA respectively (P = .428). There was no difference in rate of progression of neither LR-2 (P = 1.000), LR-3 (P = .833) or LR-4 (P = .505). At multivariate analysis, only initial LI-RADS category was an independent predictor of progression to LR-5 or LR-M for all observations (hazard ratio 6.75, P < .001), and of progression to LR-5 after DAA (hazard ratio 4.34, P = .047).ConclusionsDAA therapy does not increase progression of indeterminate observations to malignant categories. The initial LI-RADS category is an independent predictor of observations upgrade.
Lingua originaleEnglish
Numero di pagine9
RivistaLiver International
Stato di pubblicazionePublished - 2021

All Science Journal Classification (ASJC) codes

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