Miniatura

Fitxers

239424.pdf (612.25 KB)

Tipus de document

Article

Versió

Versió acceptada

Data de publicació

2021-03-19

Tots els drets reservats

Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/215146

Hepatocellular carcinoma recurrence after direct-acting antiviral therapy: an individual patient data meta-analysis

Títol de la revista

Autors

Director/Tutor

ISSN de la revista

Títol del volum

Recurs relacionat

https://doi.org/10.1136/gutjnl-2020-323663

Resum

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.

Matèries

Càncer, Metaanàlisi, Medicaments antivírics

Matèries (anglès)

Cancer, Meta-analysis, Antiviral agents

Citació

Col·leccions

Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

Citació

SAPENA, Víctor, ENEA, Marco, TORRES, Ferran, CELSA, Ciro, RÍOS, José, RIZZO, Giacomo emanuele maria, NAHON, Pierre, MARIÑO MÉNDEZ, 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. Hepatocellular carcinoma recurrence after direct-acting antiviral therapy: an individual patient data meta-analysis. _Gut_. 2021. Vol. 71, núm. 3, pàgs. 593-604. [consulta: 20 de gener de 2026]. ISSN: 0017-5749. [Disponible a: https://hdl.handle.net/2445/215146]

Exportar metadades

JSON - METS

Compartir registre