title: Favorable Prognosis in Patients with Sustained Virological Response to Antiviral Therapy, Including Interferon, for Chronic Hepatitis C Before Hepatic Resection for Hepatocellular Carcinoma.
abstract: BACKGROUND
  A sustained virological response (SVR) to interferon (IFN) therapy for chronic hepatitis C virus (HCV) reduces but does not eliminate the risk of hepatocellular carcinoma (HCC). The prognosis after hepatectomy for HCC in patients with SVR has not been fully clarified.
  
  
  METHODS
  Between 1998 and 2011, 494 patients with chronic hepatitis C underwent hepatic resection for HCC at four high-volume Centers in Japan. Out of these, 188 underwent IFN therapy for HCV. In 92 patients, SVR to IFN therapy had been achieved at the time of hepatectomy (SVR group) while in 96 patients, SVR had not (non-SVR group) had not been achieved. In the other 306 patients, IFN therapy had never been performed at all (no IFN group). The clinicopathological factors and long-term outcomes were retrospectively reviewed and compared among SVR, non-SVR and no IFN groups.
  
  
  RESULTS
  The mean time from achievement of SVR to hepatectomy for HCC was 6.2 years (range=2 months to 20 years). The preoperative serum alanine transaminase, albumin, prothrombin time, indocyanine green retention test at 15 min were significantly preserved in the SVR group. The overall survival and recurrence-free survival rates were significantly higher in the SVR group compared to patients in non-SVR and no IFN groups.
  
  
  CONCLUSIONS
  In patients undergoing hepatectomy for HCC, those with SVR had good liver function and a more favorable long-term prognosis than those without SVR. Early detection of HCC after SVR and meticulous hepatectomy with small blood loss is important in patients with HCC after hepatectomy.
authors.affiliation: Department of Surgery and Science, Kyushu University, Higashi-ku, Fukuoka, Japan kshirabe@surg2.med.kyushu-u.ac.jp.
authors.forename: Ken
authors.initials: K
authors.lastname: Shirabe
authors.affiliation: Department of Surgery, Steel Memorial Yawata Hospital, Kitakyushu, Japan.
authors.forename: Keishi
authors.initials: K
authors.lastname: Sugimachi
authors.affiliation: Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima, Japan.
authors.forename: Noboru
authors.initials: N
authors.lastname: Harada
authors.affiliation: Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima, Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kayashima
authors.affiliation: Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Maeda
authors.affiliation: Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Tsujita
authors.affiliation: Department of Surgery, Iizuka Hospital, Iizuka, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Minagawa
authors.affiliation: Department of Surgery, Iizuka Hospital, Iizuka, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Kajiyama
authors.affiliation: Department of Surgery, Iizuka Hospital, Iizuka, Japan.
authors.forename: Shohei
authors.initials: S
authors.lastname: Yoshiya
authors.affiliation: Department of Surgery and Science, Kyushu University, Higashi-ku, Fukuoka, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D000998:Antiviral Agents; D007372:Interferons
keywords: Chronic hepatitis C; hepatectomy; hepatocellular carcinoma; interferon; sustained virological response