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Outcomes of Non-B Non-C Hepatocellular Carcinoma with Reference to Patients with Interferon-Induced Hepatitis C Virus Eradication

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Purpose

This study aimed to evaluate survival outcomes in patients with non-B non-C hepatocellular carcinoma (NBNC-HCC) with reference to patients with HCC achieving sustained virological response (SVR) by preoperative interferon (IFN) treatment for chronic hepatitis C.

Methods

We examined 781 patients who underwent hepatic resection for HCC. They were classified into NBNC-HCC, SVR-HCC, and non-SVR HCC groups.

Results

Multivariate analysis for recurrence-free survival (RFS) and overall survival (OS) revealed that the adjusted hazard ratios (HR) of NBNC-HCC and non-SVR HCC groups with reference to the SVR-HCC group were 1.46 (p = 0.10) and 2.10 (p < 0.001), respectively, for RFS, and 1.69 (p = 0.024) and 2.11 (p < 0.001), respectively, for OS. Worsening of Child–Pugh grade at recurrence was confirmed in 21 patients (17.1%) with NBNC-HCC but not in those with SVR-HCC (p = 0.017, SVR vs. NBNC). In the NBNC-HCC group, hepatic resection for intrahepatic recurrence was adopted in 17.4% of patients without worsening of Child–Pugh grade at recurrence, whereas hepatic resection was not adopted in those with grade worsening. Among patients with alcoholic hepatitis, Child–Pugh grade worsening at recurrence was more frequently observed in patients with sobriety than those without sobriety (14.3% vs. 46.2%, p = 0.049).

Conclusions

NBNC-HCC patients had an increased risk for overall death as compared with those with SVR-HCC. Worsening of background liver function may reduce the chances of re-hepatic resection for recurrence and increase the risk for overall death in NBNC-HCC patients. For alcoholic hepatitis patients, sobriety may prevent deterioration of liver function after surgery.

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Authorship

All authors participated equally in the study as per the guidelines of the International Committee of Medical Journal Editors and have provided final approval for its publication.

Funding

This work was financially supported by the Health, Labour and Welfare Policy Research Grants from the Ministry of Health, Labour, and Welfare of Japan (Policy Research for Hepatitis Measures (H30-Kansei-Shitei-003)).

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Authors and Affiliations

  1. Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan

    Hiroji Shinkawa, Shogo Tanaka, Shigekazu Takemura, Tokuji Ito, Takanori Aota, Toru Miyazaki & Shoji Kubo

Authors
  1. Hiroji Shinkawa
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  2. Shogo Tanaka
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  3. Shigekazu Takemura
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  4. Tokuji Ito
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  6. Toru Miyazaki
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  7. Shoji Kubo
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Correspondence to Hiroji Shinkawa.

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Shinkawa, H., Tanaka, S., Takemura, S. et al. Outcomes of Non-B Non-C Hepatocellular Carcinoma with Reference to Patients with Interferon-Induced Hepatitis C Virus Eradication. J Gastrointest Surg 24, 1809–1817 (2020). https://doi.org/10.1007/s11605-019-04339-1

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  • DOI: https://doi.org/10.1007/s11605-019-04339-1

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