Detailed Abstract
[Poster Presentation 3 - Liver (Liver Disease/Surgery)]
[PP 3-4] IMPACT OF DIRECT-ACTING ANTIVIRAL THERAPY TIMING ON HEPATOCELLULAR CARCINOMA RECURRENCE AFTER LIVER RESECTION IN HEPATITIS C PATIENTS: A MULTICENTER RETROSPECTIVE STUDY
Woo Jin CHOI 1, Christian MAGYAR 1, Tommy IVANICS 1, Parissa TABRIZIAN 2, Joana FERRER-FÀBREGA 3, Victor HOLGIN 3, Neehar PARIKH 4, Anjana PILLAI 5, Thomas HUNOLD 4, Arndt VOGEL 7, Madhukar PATEL 6, Amit SINGAL 6, Jordan FELD 1, Bettina HANSEN 1, Gonzalo SAPISOCHIN 1
1 Surgery, University of Toronto, Canada, 2 Surgery, Mount Sinai Hospital, United States of America, 3 Surgery, Barcelona Clinic Liver Cancer (BCLC), Spain, 4 Hepatology, University of Michigan, United States of America, 5 Hepatology, University of Chicago, United States of America, 6 Surgery, University of Texas Southwestern, United States of America, 7 Hepatology , Hanover Medical School , Germany
Background : In patients with hepatitis C virus (HCV) undergoing liver resection for hepatocellular carcinoma (HCC), it is unclear whether the timing of direct-acting antiviral (DAA) therapy initiation affects HCC recurrence.
Methods : We conducted an international retrospective cohort study across seven institutions. Adults who underwent liver resection for HCV-related HCC and achieved sustained virologic response after receiving DAA therapy from 2014 onwards were included. A multivariable, time-dependent Fine-Gray competing risks mixed-effects model was used to estimate subdistribution hazard ratios (HR) for HCC recurrence.
Results : We identified 194 patients, with a median follow-up after surgery of 6.3 years (95% CI: 5.4, 7.1). The median tumor size was 2.1 cm (Q1, Q3: 1.9, 4.0 cm), and 91% had unifocal tumors. Recurrence occurred in 39.7% of patients, with a median time to recurrence of 2.0 years. The 1-, 3-, and 5-year overall survival rates were 91.1%, 74.9%, and 67.7%, respectively. The 1-, 3-, and 5-year recurrence-free survival rates were 82.3%, 51.0%, and 37.9%, respectively. DAA initiation between 5.6 and 6.6 months after surgery was associated with a higher risk of HCC recurrence (adjusted HR: 1.03; 95% CI: 1.00, 1.06). Although initiating DAA outside this time frame did not reach statistical significance, there was a linear trend toward a lower risk of HCC recurrence with earlier DAA initiation within the 24-month period before and after surgery.
Conclusions : In patients undergoing HCV-treated HCC resection, earlier DAA initiation was associated with a lower risk of HCC recurrence after surgery.
Methods : We conducted an international retrospective cohort study across seven institutions. Adults who underwent liver resection for HCV-related HCC and achieved sustained virologic response after receiving DAA therapy from 2014 onwards were included. A multivariable, time-dependent Fine-Gray competing risks mixed-effects model was used to estimate subdistribution hazard ratios (HR) for HCC recurrence.
Results : We identified 194 patients, with a median follow-up after surgery of 6.3 years (95% CI: 5.4, 7.1). The median tumor size was 2.1 cm (Q1, Q3: 1.9, 4.0 cm), and 91% had unifocal tumors. Recurrence occurred in 39.7% of patients, with a median time to recurrence of 2.0 years. The 1-, 3-, and 5-year overall survival rates were 91.1%, 74.9%, and 67.7%, respectively. The 1-, 3-, and 5-year recurrence-free survival rates were 82.3%, 51.0%, and 37.9%, respectively. DAA initiation between 5.6 and 6.6 months after surgery was associated with a higher risk of HCC recurrence (adjusted HR: 1.03; 95% CI: 1.00, 1.06). Although initiating DAA outside this time frame did not reach statistical significance, there was a linear trend toward a lower risk of HCC recurrence with earlier DAA initiation within the 24-month period before and after surgery.
Conclusions : In patients undergoing HCV-treated HCC resection, earlier DAA initiation was associated with a lower risk of HCC recurrence after surgery.
SESSION
Poster Presentation 3
Exhibition Hall 3/27/2025 2:50 PM - 3:30 PM