title: Surgical approach for hepatitis C virus-related hepatocellular carcinoma.
abstract: Hepatitis C is a strong prognostic factor for patients with hepatocellular carcinoma (HCC). Although liver resection and liver transplantation offer the chance of a cure for HCC, adequate management of co-existing infection with hepatitis C virus (HCV) is important to enable better long-term outcomes after surgery for HCV-related HCC. For patients undergoing liver resection, perioperative anti-viral treatment is recommended, since a decreased HCV viral load itself is reportedly associated with a lower tumor recurrence rate and a longer overall survival. For patients undergoing transplanatations for HCC complicated by end-stage liver disease, the post-transplant management of HCV infection is also necessary to prevent progressive graft injury caused by active hepatitis under the immunosuppressive condition that is needed after liver transplantation. Although only a few lines of solid evidence are available for postoperative antiviral treatment because of the limited indication and frequent adverse events caused by conventional high-dose combination interferon therapy, new direct acting anti-viral agents would enable interferon-free anti-viral treatment with a higher virologic response and minimal side effects.
authors.affiliation: Junichi Shindoh, Masaji Hashimoto, Goro Watanabe, Hepatobiliary-pancreatic Surgery Division, Department of Digestive Surgery, Toranomon Hospital, Tokyo 105-8470, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Shindoh
authors.affiliation: Junichi Shindoh, Masaji Hashimoto, Goro Watanabe, Hepatobiliary-pancreatic Surgery Division, Department of Digestive Surgery, Toranomon Hospital, Tokyo 105-8470, Japan.
authors.forename: Masaji
authors.initials: M
authors.lastname: Hashimoto
authors.affiliation: Junichi Shindoh, Masaji Hashimoto, Goro Watanabe, Hepatobiliary-pancreatic Surgery Division, Department of Digestive Surgery, Toranomon Hospital, Tokyo 105-8470, Japan.
authors.forename: Goro
authors.initials: G
authors.lastname: Watanabe
keywords: Adjuvant therapy; Hepatitis C; Hepatocellular carcinoma; Liver resection; Liver transplantation