Antiviral Therapy Utilization and 10-Year Outcomes in Resected Hepatitis B Virus- and Hepatitis C Virus-Related Hepatocellular Carcinoma

Daniel Q. Huang, Joseph K. Hoang, Rubayet Kamal, Pei Chien Tsai, Hidenori Toyoda, Ming Lun Yeh, Satoshi Yasuda, Jennifer Leong, Mayumi Maeda, Chung Feng Huang, Dae Won Jun, Masatoshi Ishigami, Yasuhito Tanaka, Haruki Uojima, Eiichi Ogawa, Hiroshi Abe, Yao Chun Hsu, Cheng Hao Tseng, Manaf Alsudaney, Ju Dong YangYoko Yoshimaru, Takanori Suzuki, Joanne K. Liu, Charles Landis, Chia Yen Dai, Jee Fu Huang, Wan Long Chuang, Myron Schwartz, Yock Young Dan, Carlos Esquivel, Andrew Bonham, Ming Lung Yu, Mindie H. Nguyen

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PURPOSE There are limited data on antiviral treatment utilization and its impact on long-term outcomes of hepatitis B virus (HBV)- and hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) after hepatic resection. We aimed to determine the utilization and impact of antivirals in HBV- and HCV-related HCC. Methods This cohort study included 1,906 participants (1,054 HBV-related HCC and 852 HCV-related HCC) from 12 international sites. All participants had HBV- or HCV-related HCC and underwent curative surgical resection. The primary outcome was the utilization of antiviral therapy, and the secondary outcome was long-term overall survival (OS). Results The mean (±standard deviation [SD]) age was 62.1 (±11.3) years, 74% were male, and 84% were Asian. A total of 47% of the total cohort received antiviral therapy during a mean (±SD) follow-up of 5.0 (±4.3) years. The overall antiviral utilization for participants with HBV-related HCC was 57% and declined over time, from 65% before 2010, to 60% from 2010 to 2015, to 47% beyond 2015, P <.0001. The overall utilization of antivirals for HCV-related HCC was 35% and increased over time, from 24% before 2015 to 74% from 2015 and beyond, P <.0001. The 10-year OS was lower in untreated participants for both HBV (58% v 61%) and HCV participants (38% v 82%; both P <.0001). On multivariable Cox regression analysis adjusted for relevant confounders, antiviral therapy initiated before or within 6 months of HCC diagnosis was independently associated with lower mortality in both HBV- (adjusted hazard ratio [aHR], 0.60 [95% CI, 0.43 to 0.83]; P =.002) and HCV-related HCC (aHR, 0.18 [95% CI, 0.11 to 0.31]; P <.0001). CONCLUSION Antiviral therapy is associated with long-term survival in people with HBV- or HCV-related HCC who undergo curative resection but is severely underutilized.

Original languageEnglish
Pages (from-to)790-799
Number of pages10
JournalJournal of Clinical Oncology
Issue number7
StatePublished - 1 Mar 2024


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