Long-term outcomes after curative resection of HCV-positive versus non-hepatitis related hepatocellular carcinoma: an international multi-institutional analysis

Tao Wei; Xu-Feng Zhang; Fabio Bagante; Francesca Ratti; Hugo P Marques; Olivier Soubrane; Vincent Lam; George A Poultsides; Irinel Popescu; Sorin Alexandrescu; Guillaume Martel; Aklile Workneh; Alfredo Guglielmi; Tom Hugh; Luca Aldrighetti; Timothy M Pawlik

doi:10.1016/j.hpb.2020.01.003

Long-term outcomes after curative resection of HCV-positive versus non-hepatitis related hepatocellular carcinoma: an international multi-institutional analysis

HPB (Oxford). 2020 Nov;22(11):1549-1556. doi: 10.1016/j.hpb.2020.01.003. Epub 2020 Jan 25.

Authors

Tao Wei¹, Xu-Feng Zhang², Fabio Bagante³, Francesca Ratti⁴, Hugo P Marques⁵, Olivier Soubrane⁶, Vincent Lam⁷, George A Poultsides⁸, Irinel Popescu⁹, Sorin Alexandrescu⁹, Guillaume Martel¹⁰, Aklile Workneh¹⁰, Alfredo Guglielmi¹¹, Tom Hugh¹², Luca Aldrighetti⁴, Timothy M Pawlik¹³

Affiliations

¹ Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
² Department of Hepatobiliary Surgery, Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner, Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
³ Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner, Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA; Department of Surgery, University of Verona, Verona, Italy.
⁴ Department of Surgery, Ospedale San Raffaele, Milan, Italy.
⁵ Department of Surgery, Curry Cabral Hospital, Lisbon, Portugal.
⁶ Department of Hepatobiliopancreatic Surgery, APHP, Beaujon Hospital, Clichy, France.
⁷ Department of Surgery, Westmead Hospital, Sydney, Australia.
⁸ Department of Surgery, Stanford University, Stanford, CA, USA.
⁹ Department of Surgery, Fundeni Clinical Institute, Bucharest, Romania.
¹⁰ Department of Surgery, University of Ottawa, Ottawa, Canada.
¹¹ Department of Surgery, University of Verona, Verona, Italy.
¹² Department of Surgery, The University of Sydney, School of Medicine, Sydney, Australia.
¹³ Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner, Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA. Electronic address: Tim.Pawlik@osumc.edu.

PMID: 31987739
DOI: 10.1016/j.hpb.2020.01.003

Abstract

Background: To define the chronological changes of long-term survival among patients with non-hepatitis-related hepatocellular carcinoma (Non-Hep-HCC) versus hepatitis C-related HCC (HCV-HCC) over the last two decades.

Methods: Patients who underwent curative-intent resection for HCC between 2000 and 2017 were identified from an international multi-institutional database. Overall (OS) and recurrence-free survival (RFS) were analyzed and compared among Non-Hep-HCC versus HCV-HCC patients. Propensity score matching (PSM) was utilized to mitigate residual bias.

Results: Among 617 patients, 196 (31.8%) patients had HCV-HCC, whereas 421 (68.2%) patients had Non-Hep-HCC. While patients with HCV-HCC had an improvement in OS over time (5-year OS, 2000-2009 55% vs. 2010-2017 67%, p = 0.034), OS among patients with Non-Hep-HCC remain unchanged (5-year OS, 2000-2009 53% vs. 2010-2017 52%, p = 0.905). In the matched cohort, patients with HCV-HCC had a worse OS versus patients with Non-Hep-HCC during 2000 and 2009 (5-year OS, 12% vs. 63%, p = 0.029), but significantly better OS from 2010 to 2017 than patients with Non-Hep-HCC (5-year OS, 86% vs. 73%, p = 0.035). The recurrence timing, patterns and re-treatments were comparable among Non-Hep-HCC and HCV-HCC patients.

Conclusion: While OS of patients with HCV-HCC improved over time, the long-term survival of patients with Non-Hep-HCC patients remained unchanged and was more unfavorable.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Carcinoma, Hepatocellular* / surgery
Hepatitis C* / complications
Hepatitis C* / diagnosis
Humans
Liver Neoplasms* / surgery
Neoplasm Recurrence, Local
Propensity Score
Retrospective Studies