Eradication of hepatitis C virus profoundly prolongs survival in hepatocellular carcinoma patients receiving transarterial chemoembolization

Background & Aim Adjuvant pegylated interferon plus ribavirin treatment (PegIFN/RBV) reduces recurrence and prolongs survival in early stage hepatocellular carcinoma (HCC) patients with chronic hepatitis C (CHC) infection receiving resection or ablation. However, the impact of antiviral therapy in intermediate and advanced stage of CHC-HCC patients is uncertain. This study aimed to investigate the impact PegIFN/RBV treatment on recurrence free interval and survival in HCC patients receiving transarterial chemoembolization (TACE) Methods From 2010 to 2013, 274 CHC patients from a 1073-patients based cohort composed of freshly diagnosed HCC and receiving TACE treatment the Chang Gung Memorial Hospital, Linkou Medical Center were recruited. Propensity score matching (PSM) (age, gender, AST to Platelet Ratio Index (APRI), tumor size, tumor number and Child-Turcotte-Pugh score) with the ratio 1:2 for patients with and without PegIFN/RBV treatment was performed. Statistics were performed with SPSS V.20 (IBM, USA) Results After matching, 153 patients were analyzed and twenty-seven patients (17.6%) achieved sustained virologic response (SVR). The two-year cumulative overall survival rate and recurrence free survival rate among patients with SVR, non-SVR, and untreated erre 85.2% vs. 58.3% vs. 69.6% (P = 0.001) and 73.3% vs. 53.8% vs. 58.5% (P = 0.013). By Cox regression analysis, non-SVR, untreated, increase CTP score and non-responder to TACE were independent factors related to mortality Conclusions The SVR achieved by PegIFN/RBV treatment markedly improves survival and reduces tumor recurrence in CHC-HCC patients receiving TACE treatment after complete response. This article is protected by copyright. All rights reserved.