title: Sustained virologic response achieved after curative treatment of hepatitis C virus-related hepatocellular carcinoma as an independent prognostic factor.
abstract: OBJECTIVE
  Whether an antiviral interferon (IFN)-based therapy (IBT) after curative treatment of hepatocellular carcinoma (HCC) improves the prognosis in patients with hepatitis C virus (HCV)-related HCC remains to be elucidated.
  
  
  METHODS
  A total of 178 patients within the Milan criteria underwent curative treatment for HCV-related HCC. Both the time to beyond the Milan criteria (TTBMC) and overall survival (OS) were compared between the sustained virologic response (SVR) (IFN with SVR, n = 22), non-SVR (IFN without SVR, n = 19), and non-IBT (control, n = 82) groups using propensity score matching analysis. Prognostic factors to predict survival were also determined by the Cox proportional-hazards model.
  
  
  RESULTS
  TTBMC in the IFN with SVR group was significantly longer than those in the control and IFN without SVR groups (P < 0.001 and P = 0.006, respectively), although no significant difference existed between the IFN without SVR and control groups. Similarly, OS of the IFN with SVR group was significantly longer than that of the control and IFN without SVR groups (P < 0.001 and P = 0.029, respectively), although no significant difference existed between the IFN without SVR and control groups. The Cox proportional-hazards model identified SVR as an independent prognostic factor in these patients. The IFN with SVR group showed a 0.096-fold decrease in mortality risk compared with the control group (95% confidence intervals = 0.023-0.405; P = 0.001).
  
  
  CONCLUSIONS
  Elimination of HCV after curative treatment of patients with HCC within the Milan criteria inhibits recurrence and contributes to a preferential prognosis.
authors: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Naoya
authors: N
authors: Kanogawa
authors: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Sadahisa
authors: S
authors: Ogasawara
authors: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Tetsuhiro
authors: T
authors: Chiba
authors: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Tomoko
authors: T
authors: Saito
authors: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Tenyu
authors: T
authors: Motoyama
authors: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Eiichiro
authors: E
authors: Suzuki
authors: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Yoshihiko
authors: Y
authors: Ooka
authors: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Akinobu
authors: A
authors: Tawada
authors: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Tatsuo
authors: T
authors: Kanda
authors: Department of Gastroenterology, Kikkoman General Hospital, Noda, Japan.
authors: Shigeru
authors: S
authors: Mikami
authors: Department of Gastroenterology, Kimitsu Chuo Hospital, Kisarazu, Japan.
authors: Ryosaku
authors: R
authors: Azemoto
authors: Department of Surgery, Kimitsu Chuo Hospital, Kisarazu, Japan.
authors: Takashi
authors: T
authors: Kaiho
authors: Department of Gastroenterology, Numazu City Hospital, Numazu, Japan.
authors: Masami
authors: M
authors: Shinozaki
authors: Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Masayuki
authors: M
authors: Ohtsuka
authors: Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Masaru
authors: M
authors: Miyazaki
authors: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors: Osamu
authors: O
authors: Yokosuka
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D005260:Female; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control / Q000821:virology; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D057216:Propensity Score; D016016:Proportional Hazards Models; D012008:Recurrence; D015996:Survival Rate
chemical_list: D000998:Antiviral Agents; D007372:Interferons
keywords: Milan criteria; hepatitis C virus; hepatocellular carcinoma; interferon; sustained virologic response