In a retrospective cohort study reported in the Journal of Clinical Oncology, Daniel Q. Huang, MBBS, and colleagues found that the use of antiviral therapy was associated with improved overall survival among patients with hepatitis B virus (HBV)- or hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) who underwent curative resection.
Daniel Q. Huang, MBBS
Study Details
The study involved 1,906 patients from 12 international sites (3 in the United States and 9 in 4 Asian countries) in the REAL-HCC consortium who underwent curative resection of HBV-related (n = 1,054) or HCV-related (n = 852) HCC between January 1992 and August 2022. Overall, 84% of patients were Asian. The primary outcomes of interest were use of antiviral therapy and overall survival.
Key Findings
Over a mean follow-up of 5.0 (± 4.3) years, 47% of patients in the entire cohort received antiviral therapy. Overall antiviral use among patients with HBV-related HCC was 57%, declining from 65% before 2010, to 60% from 2010 to 2015, and to 47% after 2015 (overall P < .0001). Overall antiviral use among patients with HCV-related HCC was 35%, increasing from 24% before 2015 to 74% from 2015 and beyond (overall P < .0001).
Overall, the 10-year overall survival rates among patients who did vs did not receive antiviral therapy were 61% vs 58% (P < .0001) among patients with HBV-related HCC and 82% vs 38% (P < .0001) among those with HCV-related HCC. On multivariate analysis, starting antiviral therapy before or within 6 months after diagnosis of HCC was associated with a reduced risk of mortality among patients with HBV-related (adjusted hazard ratio [HR] = 0.60, 95% CI = 0.43–0.83, P = .002) and HCV-related HCC (adjusted HR = 0.18, 95% CI = 0.11–0.31, P < .0001).
The investigators concluded: “Antiviral therapy is associated with long-term survival in people with HBV- or HCV-related HCC who undergo curative resection but is severely underutilized.”
Mindie H. Nguyen, MD, of the Division of Gastroenterology and Hepatology, Stanford University Medical Center, is the corresponding author of the Journal of Clinical Oncology article.
Disclosure: The study was supported by the Singapore Ministry of Health’s National Medical Research Council, Center of Excellence for Metabolic Associated Fatty Liver Disease, National Sun Yat-sen University, and others. For full disclosures of the study authors, visit ascopubs.org.
