Recurrence rate and prognosis of patients with hepatocellular carcinoma that developed after elimination of hepatitis C virus RNA by interferon therapy. A closed cohort study including matched control patients.
BACKGROUND
Although hepatocellular carcinoma does develop after sustained response to interferon (IFN) in patients with chronic hepatitis C, details on the clinical prognosis have not been elucidated yet.


METHODS
Among 12 patients with liver cancer arising after hepatitis C virus (HCV) elimination, 10 patients with potentially curative ablation were prospectively analyzed. Matched control patients were chosen from a patient list of surgical resection on the basis of age, sex, cancer stage, and severity of liver disease. Control patients were recruited with a ratio of 1:4, and all the control patients had positive HCV-RNA.


RESULTS
One (10.0%) of 10 patients with virus elimination and 31 (77.5%) of 40 control patients eventually developed cancer recurrence during the same follow-up period. Cancer recurrence rates of the 10 cases and 40 controls were 10.0 and 55.3% at the 3rd year, and 10.0 and 72.2% at the 5th year, respectively. The recurrence rate in the 10 cases of virus elimination was significantly lower than that of control patients (p = 0.012).


CONCLUSIONS
Although hepatocellular carcinogenesis after elimination of HCV-RNA by IFN treatment did rarely occur, the recurrence rate after radical therapy was significantly lower than that of untreated or non-responsive patients.
Ikeda
Kenji
K
Department of Gastroenterology, Toranomon Hospital, and Okinaka Memorial Institute for Medical Research, Tokyo, Japan. ikedakenji@tora.email.ne.jp
Kobayashi
Masahiro
M
Saitoh
Satoshi
S
Someya
Takashi
T
Hosaka
Tetsuya
T
Akuta
Norio
N
Suzuki
Fumitaka
F
Tsubota
Akihito
A
Suzuki
Yoshiyuki
Y
Arase
Yasuji
Y
Kumada
Hiromitsu
H
D000998:Antiviral Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000628:therapy / Q000821:virology; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000235:genetics*; D006498:Hepatectomy; D019698:Hepatitis C, Chronic / Q000628:therapy / Q000821:virology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000628:therapy / Q000821:virology; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000628:therapy / Q000821:virology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology; D011379:Prognosis; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis*; D011994:Recombinant Proteins; D015996:Survival Rate; D016896:Treatment Outcome
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins