Influence of Interferon-free Direct-acting Antiviral Therapy on Primary Hepatocellular Carcinoma Recurrence: A Landmark Time Analysis and Time-dependent Extended Cox Proportional Hazards Model Analysis
Open Access
- 1 January 2020
- journal article
- research article
- Published by Japanese Society of Internal Medicine in Internal Medicine
- Vol. 59 (7), 901-907
- https://doi.org/10.2169/internalmedicine.3382-19
Abstract
Objective The influence of interferon (IFN)-free direct-acting antiviral (DAA) on hepatocellular carcinoma (HCC) recurrence remains unclear. Previous retrospective analyses revealed that the time interval between HCC curative treatment and IFN-free DAA induction is the critical factor affecting HCC recurrence. Thus, this study aimed to examine the influence of DAA therapy on HCC recurrence considering this interval. Methods Factors contributing to HCC recurrence were retrospectively analyzed using a landmark time analysis and time-dependent extended Cox proportional hazards model. Patients After screening 620 patients who were diagnosed with primary HCC from January 2001 to December 2016, 76 patients with early-stage (primary and solitary) disease who received curative treatment and were positive for serum hepatitis C virus RNA were included. Results HCC recurrence was observed in 8 of 17 (47.1%) patients who had received IFN-free DAA therapy and 45 of 59 (76.3%) who had not. No significant difference was seen between the IFN-free DAA (-) and IFN-free DAA (+) groups in the landmark time and time-dependent Cox proportional hazards model analyses. However, IFN-free DAA therapy tended to decrease the HCC recurrence rate after curative treatment for primary HCC in patients with chronic hepatitis. In addition, IFN-free DAA therapy tended to decrease the second HCC recurrence rate after treatment for the first HCC recurrence. Conclusion Our results, with a consideration of the time interval between HCC curative treatment and IFN-free DAA induction, showed that IFN-free DAA therapy was not associated with early-stage HCC recurrence after curative treatment.This publication has 35 references indexed in Scilit:
- Effect of interferon therapy on first and second recurrence after resection of hepatitis C virus‐related hepatocellular carcinomaHepatology Research, 2012
- Effect of Previous Interferon Treatment on Outcome After Curative Treatment for Hepatitis C Virus-Related Hepatocellular CarcinomaDigestive Diseases and Sciences, 2011
- Effect of pegylated interferon therapy on intrahepatic recurrence after curative treatment of hepatitis C virus-related hepatocellular carcinomaInternational Journal of Clinical Oncology, 2010
- Hepatitis C virus-induced hepatocarcinogenesisJournal of Hepatology, 2009
- Analyzing survival curves at a fixed point in timeStatistics in Medicine, 2007
- FIB-4: An inexpensive and accurate marker of fibrosis in HCV infection. comparison with liver biopsy and fibrotestHepatology, 2007
- Prevention of hepatocellular carcinoma recurrence with alpha-interferon after liver resection in HCV cirrhosisHepatology, 2006
- Hepatocellular carcinoma and hepatitis C in the United StatesHepatology, 2002
- Hepatocellular carcinoma and hepatitis C in the United StatesHepatology, 2002
- TIME-DEPENDENT COVARIATES IN THE COX PROPORTIONAL-HAZARDS REGRESSION MODELAnnual Review of Public Health, 1999