Dropout rate from the liver transplant waiting list because of hepatocellular carcinoma progression in hepatitis C virus–infected patients treated with direct‐acting antivirals
Dropout rate from the liver transplant waiting list because of hepatocellular carcinoma progression in hepatitis C virus–infected patients treated with direct‐acting antivirals
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接受直接抗病毒药物治疗的丙型肝炎病毒感染患者因肝细胞癌进展而从肝移植等待名单中退出的比例
DOI：
10.1002/lt.24790
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发表时间：
2017
影响因子：
4.6
通讯作者：
F. Russo
中科院分区：
文献类型：
--
作者：
A. Zanetto;S. Shalaby;A. Vitale;C. Mescoli;A. Ferrarese;M. Gambato;E. Franceschet;G. Germani;M. Senzolo;A. Romano;P. Angeli;M. Rugge;F. Farinati;D. Forton;U. Cillo;P. Burra;F. Russo
在既往肿瘤学完全缓解的肝硬化患者中，直接作用抗病毒（DAA）治疗后肝细胞癌（HCC）复发率增加的担忧已经提出。目前缺乏关于DAA治疗HCV对等待肝移植（LT）的活动性HCC和HCV相关肝硬化患者的等待名单脱落率的影响的数据。2015年1月至2016年5月期间在帕多瓦肝移植中心接受LT的HCV‐HCC患者被认为有资格参加本研究。入组后，根据患者在等待LT期间是否接受DAA治疗，将患者分为2组。收集每例患者的临床、血清学和病毒学数据。在基线和随访（FU）期间对HCC特征进行放射学评价。对于移植患者，进行外植体的病理学评估并计算复发率。共入组了23例接受DAA治疗的患者和23例对照患者。两组之间LT列表时的HCC特征相当。中位随访时间分别为10个月和7个月，在此期间登记了2/23例（8.7%）和1/23例（4.3%）因HCC进展而脱落的事件（P = 0.90）。放射学进展方面无显著差异（P = 0.16）。23名患者中共有9名（39%）和23名对照中有14名（61%）接受了LT，组织病理学分析显示，HCC结节的中位数和肿瘤总体积、肿瘤分化或微血管侵袭方面没有差异。在LT后FU期间，1/8（12.5%）例DAA治疗患者和1/12（8.3%）例对照患者发生HCC复发（P = 0.60）。总之，在等待LT的HCV-HCC患者中，病毒根除似乎与肿瘤进展导致的脱落风险增加无关。肝移植23 1103-1112 2017 AASLD。
Concerns about an increased hepatocellular carcinoma (HCC) recurrence rate following direct‐acting antiviral (DAA) therapy in patients with cirrhosis with a prior complete oncological response have been raised. Data regarding the impact of HCV treatment with DAAs on wait‐list dropout rates in patients with active HCC and HCV‐related cirrhosis awaiting liver transplantation (LT) are lacking. HCV‐HCC patients listed for LT between January 2015 and May 2016 at Padua Liver Transplant Center were considered eligible for the study. After enrollment, patients were divided into 2 groups, depending on whether they underwent DAA treatment while awaiting LT or not. For each patient clinical, serological, and virological data were collected. HCC characteristics were radiologically evaluated at baseline and during follow‐up (FU). For transplanted patients, pathological assessment of the explants was performed and recurrence rates were calculated. A total of 23 patients treated with DAAs and 23 controls were enrolled. HCC characteristics at time of LT listing were comparable between the 2 groups. Median FU was 10 and 7 months, respectively, during which 2/23 (8.7%) and 1/23 (4.3%) dropout events due to HCC progression were registered (P = 0.90). No significant differences in terms of radiological progression were highlighted (P = 0.16). A total of 9 out of 23 (39%) patients and 14 out of 23 (61%) controls underwent LT, and histopathological analysis showed no differences in terms of median number and total tumor volume of HCC nodules, tumor differentiation, or microvascular invasion. During post‐LT FU, 1/8 (12.5%) DAA‐treated patient and 1/12 (8.3%) control patient experienced HCC recurrence (P = 0.60). In conclusion, viral eradication does not seem to be associated with an increased risk of dropout due to neoplastic progression in HCV‐HCC patients awaiting LT. Liver Transplantation 23 1103–1112 2017 AASLD.
DOI：
10.1016/s0015-6264(78)80335-6
发表时间：
1986
期刊：
The New Zealand medical journal
影响因子：
--
作者：
D. Woodfield
通讯作者：
D. Woodfield
影响因子：
25.7
作者：
C. Zavaglia;S. Okolicsanyi;L. Cesarini;C. Mazzarelli;V. Pontecorvi;A. Ciaccio;M. Strazzabosco;L. Belli
通讯作者：
C. Zavaglia;S. Okolicsanyi;L. Cesarini;C. Mazzarelli;V. Pontecorvi;A. Ciaccio;M. Strazzabosco;L. Belli