| Institution: | 1. Section of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, 330 Cedar Street, New Haven, CT 06510;2. Section of Medical Oncology, Department of Internal Medicine, Yale School of Medicine, 330 Cedar Street, New Haven, CT 06510;3. Section of Digestive Diseases and Yale Liver Center, Yale School of Medicine, 330 Cedar Street, New Haven, CT 06510;4. Yale Cancer Center, Yale School of Medicine, 330 Cedar Street, New Haven, CT 06510;1. Department of Diagnostic Radiology, Tan Tock Seng Hospital 11, Jalan Tan Tock Seng Singapore;2. Department of Otorhinolaryngology, Tan Tock Seng Hospital 11, Jalan Tan Tock Seng Singapore;1. Department of General Surgery, Saint Joseph Hospital, 1375 E. 19th Ave., Denver, CO 80218;2. Department of Vascular Therapy and Interventional Radiology, Colorado Permanente Medical Group, 2045 Franklin St., Denver, CO 80205;1. Neurointerventional and Interventional Vascular Unit, Hôpital Pasteur 2, University of Nice, 30 voie Romaine, Nice 06000, France;2. Service de Réanimation, Hôpital Pasteur 2, University of Nice, 30 voie Romaine, Nice 06000, France;3. Service de Radiologie, Hôpital Pasteur 2, University of Nice, 30 voie Romaine, Nice 06000, France;1. Department of Pediatric Radiology, Division of Interventional Radiology, Akron Children’s Hospital, One Perkins Square, Akron, OH 44308;2. Department of Radiology, Cleveland Clinic Akron General Hospital, Akron, Ohio;3. Department of Radiology, Case Western Reserve University MetroHealth Medical Center, Cleveland, Ohio;4. Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania |
| Abstract: | PurposeTo investigate the impact of direct-acting antivirals (DAAs) and 12-week sustained virologic response (SVR12) in patients with hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) treated by interventional oncology (IO) therapies.Materials and MethodsRetrospective analysis of patients diagnosed from 2005 to 2016 with HCC and receiving IO therapies. A total of 478 patients met inclusion criteria. Patients were age 29–90 years (mean 63.6 ± 9.4 years) and 78.9% (n =3 77) male. Two hundred and eighty-five (57%) patients had chronic HCV, 93 (33%) received DAAs, and 63 (68%) achieved SVR12. Liver function, tumor characteristics, and IO therapy including ablation, image-guided transcatheter tumor therapies (ITTT) (eg, chemoembolization and radioembolization), and combination locoregional therapy were assessed in analysis.ResultsMedian overall survival (OS) of the cohort was 26.7 months (95% confidence interval CI] 21.9–29.9). OS for ablation, combination locoregional therapy and ITTT, was 37.3 (CI 30.7–49.9), 29.3 (CI 24.2–38.0), and 19.7 months (CI 16.5–22.8), respectively (P < .0001). OS in patients with HCV was 30.7 months (CI 24.2–35.2) versus 22.2 months in non-HCV patients (CI 17.8–27.8, P = .03). Patients with HCV who received DAA had higher survival, 49.2 months (CI 36.5–not reached) versus those not receiving DAA, 18.5 months (CI 14.1–25.3, P < .0001). OS was 71.8 months (CI 42.3–not reached) for patients who achieved SVR12 after DAA versus 26.7 months in the non-SVR12 group (CI 15.9–31.1, P < .0001). Multivariable analysis revealed independent factors for OS including IO treatment type, DAA use and achieving SVR12 (P < .05).ConclusionsDAA use and SVR12 is associated with higher OS in patients with HCV-related HCC treated by IO therapies. |
