HCV clearance by direct antiviral therapy and occurrence/recurrence of hepatocellular carcinoma:still an issue?

作     者：Francesco Paolo Russo Martina Tessari Angela Imondi Erica Nicola Lynch Fabio Farinati 

作者机构：Department of SurgeryOncology and GastroenterologySection of GastroenterologyPadua University HospitalPadua 35128Italy 

出 版 物：《Hepatoma Research》 (肝癌研究（英文版）)

年 卷 期：2018年第4卷第6期

页      面：90-103页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Hepatitis C virus direct-acting antivirals eradication hepatocellular carcinoma occurrence recurrence 

摘      要：New regimens with direct-acting antivirals (DAAs) agents have changed both efficacy and safety of hepatitis C virus (HCV)-treatment, as almost all patients can be treated and cured at any stage of liver disease. The rates of sustained virological response to currently available combinations exceed 95% in real-life practice. However, conflicting results have been produced on the occurrence/recurrence of hepatocellular carcinoma (HCC) in patients with HCV-associated cirrhosis treated with DAAs. In this review we analyse the data available in the literature in order to elucidate the impact of DAAs on the risk of HCC occurrence in patients without previous history of tumor, and of recurrence after successful treatment of the tumor. Data on de novo HCC incidence were quite homogeneous, suggesting that the treatment with DAAs does not modify the risk of HCC developing during the first 6-12 months after HCV eradication. On the contrary, HCC recurrence rates after DAAs were extremely variable across different studies, reflecting a large heterogeneity in this clinical setting. The possibility that treatment with DAAs may favour tumour growth and spread in individual patients with active HCC foci is supported by some observations but remains unproven.