Regional Differences in Clinical Presentation and Prognosis of Patients With Post–Sustained Virologic Response Hepatocellular Carcinoma

作者：Hidenori Toyoda, Mounika Kanneganti, Jonathan Melendez-Torres, Neehar D. Parikh, Prasun K. Jalal, Federico Piñero, Manuel Mendizábal, Ezequiel Ridruejo, Hugo Cheinquer, Andrea Casadei‐Gardini, Arndt Weinmann, Markus Peck‐Radosavljevic, Jean‐François Dufour, Pompilia Radu, Gamal Shiha, Riham Soliman, Shiv Kumar Sarin, Manoj Kumar, Jing‐Houng Wang, Pisit Tangkijvanich, Wattana Sukeepaisarnjaroen, Masanori Atsukawa, Haruki Uojima, Akito Nozaki, Makoto Nakamuta, Koichi Takaguchi, Atsushi Hiraoka, Hiroshi Abe, Kentaro Matsuura, Tsunamasa Watanabe, Noritomo Shimada, Kunihiko Tsuji, Toru Ishikawa, Shigeru Mikami, Ei Itobayashi, Amit G. Singal, Philip J. Johnson · 发表于：Clinical Gastroenterology and Hepatology · 年份：2023 · DOI：10.1016/j.cgh.2023.06.026 · 被引用次数：9 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Hepatitis C virus research、Liver Disease Diagnosis and Treatment

BACKGROUND & AIMS: Widespread use of direct-acting antivirals for hepatitis C virus infection has been paralleled with increased numbers of patients with hepatocellular carcinoma (HCC) after achieving sustained virologic response (post-SVR HCC) worldwide. Few data compare regional differences in the presentation and prognosis of patients with post-SVR HCC. METHODS: We identified patients with advanced fibrosis (F3/F4) who developed incident post-SVR HCC between March 2015 and October 2021 from 30 sites in Europe, North America, South America, the Middle East, South Asia, East Asia, and Southeast Asia. We compared patient demographics, liver dysfunction, and tumor burden by region. We compared overall survival by region using Kaplan-Meier analysis and identified factors associated with survival using multivariable Cox regression analysis. RESULTS: Among 8796 patients with advanced fibrosis or cirrhosis who achieved SVR, 583 (6.6%) developed incident HCC. There was marked regional variation in the proportion of patients detected by surveillance (range: 59.5%-100%), median maximum tumor diameter (range, 1.8-5.0 cm), and the proportion with multinodular HCC (range, 15.4%-60.8%). The prognosis of patients highly varied by region (hazard ratio range, 1.82-9.92), with the highest survival rates in East Asia, North America, and South America, and the lowest survival rates in the Middle East and South Asia. After adjusting for geographic region, HCC surveillance was associated with ea...