Antiviral Therapy Found to Improve Long-Term Survival for Patients With HBV- and HCV-Related Hepatocellular Carcinoma

According to an international, multicenter cohort study, antiviral therapy is associated with long-term survival among patients with hepatitis B virus (HBV)- or hepatitis C virus (HCV)-related hepatocellular carcinoma who undergo curative resection, but is severely underutilized.

Daniel Q. Huang, MBBS, National university of Singapore, and coauthors stated, “Antiviral therapy can help stabilize the underlying liver disease and may help lower the risk of [hepatocellular carcinoma] recurrence and de novo [hepatocellular carcinoma] development.” They went on, “Data regarding the utilization of antiviral therapy, and 10-year outcomes, in patients with viral hepatitis and [hepatocellular carcinoma] who undergo partial hepatectomy with curative intent are limited.”

This large, multicenter, real-world, retrospective study included 1906 patients, 1054 with HBV-related and 852 with HCV-related hepatocellular carcinoma. All patients underwent curative surgical resection between January 1992 and August 2022. The primary outcome was the utilization of antiviral therapy, with a secondary outcome of long-term overall survival (OS).

The mean follow-up duration was 5.0 years. Of the total cohort, 47% of patients received antiviral therapy. The overall antiviral utilization for patients with HBV-related hepatocellular carcinoma was 57%, which declined over time (65% prior to 2010, 60% from 2010 to 2015, 47% after 2015; P < .0001). For patients with HCV-related hepatocellular carcinoma, the overall antiviral utilization was 35%, and increased over time (24% prior to 2015, 74% from 2015 and after; P < .0001). The 10-year OS was lower for untreated patients, both with HBV (58% vs 61%) and HCV (38% vs 82%; both P < .0001). Antiviral therapy being initiated before or within 6 months of hepatocellular carcinoma diagnosis was independently associated with lower mortality for both patients with HBV- and HCV-related hepatocellular carcinoma.

Dr Huang et al concluded, “antiviral treatment was associated with substantial improvements in OS but was severely underutilized” for HBV- and HCV-related [hepatocellular carcinoma].

“These findings are concerning and call for greater awareness and multidisciplinary collaboration between surgeons, physicians, and health care policymakers to improve the utilization of lifesaving antiviral therapy for patients with HBV- and HCV-related [hepatocellular carcinoma],” they explained.

Source:

Huang DQ, Hoang JK, Kamal R, et al. Antiviral therapy utilization and 10-year outcomes in resected hepatitis B virus- and hepatitis C virus-related hepatocellular carcinoma. J Clin Oncol. Published online January 4, 2024. doi:10.1200/JCO.23.00757