Please use this identifier to cite or link to this item:
http://hdl.handle.net/2445/215146
Title: | Hepatocellular carcinoma recurrence after direct-acting antiviral therapy: an individual patient data meta-analysis |
Author: | Sapena, Víctor Enea, Marco Torres, Ferran Celsa, Ciro Rios, Jose Rizzo, Giacomo Emanuele Maria Nahon, Pierre Mariño, Zoe Tateishi, Ryosuke Minami, Tatsuya Sangiovanni, Angelo Forns Bernhardt, Xavier Toyoda, Hidenori Brillanti, Stefano Conti, Fabio Degasperi, Elisabetta Yu, Ming-Lung Tsai, Pei-Chien Jean, Kevin El Kassas, Mohamed Shousha, Hend Ibrahim Omar, Ashraf Zavaglia, Claudio Nagata, Hiroko Nakagawa, Mina Asahina, Yasuhiro Singal, Amit G. Murphy, Cian Kohla, Mohamed Masetti, Chiara Dufour, Jean-François Merchante, Nicolas Cavalletto, Luisa Chemello, Liliana LC. Pol, Stanislas Crespo, Javier Calleja, Jose Luís Villani, Rosanna Serviddio, Gaetano Zanetto, Alberto Shalaby, Sarah Russo, Francesco Paolo Bielen, Rob Trevisani, Franco Cammà, Calogero Bruix Tudó, Jordi Cabibbo, Giuseppe Reig, María |
Keywords: | Càncer Metaanàlisi Medicaments antivírics Cancer Meta-analysis Antiviral agents |
Issue Date: | 19-Mar-2021 |
Publisher: | BMJ Publishing Group |
Abstract: | Objective: The benefit of direct-acting antivirals (DAAs) against HCV following successful treatment of hepatocellular carcinoma (HCC) remains controversial. This meta-analysis of individual patient data assessed HCC recurrence risk following DAA administration. Design: We pooled the data of 977 consecutive patients from 21 studies of HCV-related cirrhosis and HCC, who achieved complete radiological response after surgical/locoregional treatments and received DAAs (DAA group). Recurrence or death risk was expressed as HCC recurrence or death per 100 person-years (100PY). Propensity score-matched patients from the ITA.LI.CA. cohort (n=328) served as DAA-unexposed controls (no-DAA group). Risk factors for HCC recurrence were identified using random-effects Poisson. Results: Recurrence rate and death risk per 100PY in DAA-treated patients were 20 (95% CI 13.9 to 29.8, I2=74.6%) and 5.7 (2.5 to 15.3, I2=54.3), respectively. Predictive factors for recurrence were alpha-fetoprotein logarithm (relative risk (RR)=1.11, 95% CI 1.03 to 1.19; p=0.01, per 1 log of ng/mL), HCC recurrence history pre-DAA initiation (RR=1.11, 95% CI 1.07 to 1.16; p<0.001), performance status (2 vs 0, RR=4.35, 95% CI 1.54 to 11.11; 2 vs 1, RR=3.7, 95% CI 1.3 to 11.11; p=0.01) and tumour burden pre-HCC treatment (multifocal vs solitary nodule, RR=1.75, 95% CI 1.25 to 2.43; p<0.001). No significant difference was observed in RR between the DAA-exposed and DAA-unexposed groups in propensity score-matched patients (RR=0.64, 95% CI 0.37 to 1.1; p=0.1). Conclusion: Effects of DAA exposure on HCC recurrence risk remain inconclusive. Active clinical and radiological follow-up of patients with HCC after HCV eradication with DAA is justified. |
Note: | Versió postprint del document publicat a: https://doi.org/10.1136/gutjnl-2020-323663 |
It is part of: | Gut, 2021, vol. 71, num.3, p. 593-604 |
URI: | http://hdl.handle.net/2445/215146 |
Related resource: | https://doi.org/10.1136/gutjnl-2020-323663 |
ISSN: | 0017-5749 |
Appears in Collections: | Articles publicats en revistes (Medicina) Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) |
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