ArticleGastroenterology2019
Direct-Acting Antiviral Therapy Not Associated With Recurrence of Hepatocellular Carcinoma in a Multicenter North American Cohort Study.
Article in Gastroenterology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 1 of them a synthesis that pooled it.
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Who cites it
79 citing papers in PubMed, 1 synthesis or guideline pooled it, 161 citations in OpenAlex.
- Efficacy and Long-Term Outcomes of Direct-Acting Antivirals in Patients with Hepatitis C Virus-Related Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis.Gut and liver · 2026Pooled it
- Less Restrictive Medicaid Policies for Direct-Acting Antiviral Access Are Associated With Greater Declines in Hepatocellular Carcinoma Deaths.Cancer medicine · 2026Article
- Impact of sustained virological response on prognosis after hepatectomy for hepatitis C-related hepatocellular carcinoma: a retrospective cohort study.BMC infectious diseases · 2026Article
- Should direct-acting antiviral be considered for all patients with HCV-related hepatocellular carcinoma?: Reply to correspondence on "Direct-acting antiviral therapy for patients with HCV-related hepatocellular carcinoma: A nationwide cohort study".Clinical and molecular hepatology · 2026Article
- Editorial on "Direct-acting antiviral therapy for patients with HCV-related hepatocellular carcinoma: A nationwide cohort study".Clinical and molecular hepatology · 2026Article
- 2025 KASL clinical practice guidelines for management of hepatitis C.Clinical and molecular hepatology · 2026Article
- Development of a nomogram for predicting the long-term risk of hepatocellular carcinoma after antiviral treatment for hepatitis C.BMC gastroenterology · 2025Article
- [Recent Advances in the Treatment of Chronic Hepatitis C].The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2025Review
- Evolving roles of systemic therapy in hepatocellular carcinoma: neoadjuvant and adjuvant strategies.Journal of liver cancer · 2025Article
- Evaluation and Management of Unresectable Hepatocellular Carcinoma: Multidisciplinary Indian Consensus Statements from a Delphi Panel.South Asian journal of cancer · 2025Review
- Absence of Viral Replication Is Associated With Improved Outcome in Anti-HCV-Positive Patients With Hepatocellular Carcinoma.Liver international : official journal of the International Association for the Study of the Liver · 2025Article
- Extrahepatic Cancer Risk in Patients with Hepatitis C Virus Infection Treated with Direct-Acting Antivirals.Microorganisms · 2024Review
- The Real-World Efficacy and Safety of Direct-Acting Antivirals for Chronic Hepatitis C in Patients Active Malignancies.Cancers · 2024Article
- Impact of DAA Treatment for HCV on Hepatocellular Carcinoma in a Predominately African American Population.Journal of gastrointestinal cancer · 2024Article
- Incidence of Liver and Non-liver Cancers After Hepatitis C Virus Eradication: A Population-Based Cohort Study.Drugs - real world outcomes · 2024Article
- Unmet needs in the post-direct-acting antivirals era: The risk and molecular mechanisms of hepatocellular carcinoma after hepatitis C virus eradication.Clinical and molecular hepatology · 2024Review
- Direct-Acting Antiviral Therapy for Patients with Chronic Hepatitis C Infection and Decompensated Cirrhosis.Digestive diseases and sciences · 2024Review
- Long-term outcome of adjuvant radiotherapy upon postoperative relapse of centrally located hepatocellular carcinoma: a real-world study.Scientific reports · 2024Article
- Analyzing risk factors and developing a stratification system for hepatocellular carcinoma recurrence after interferon-free direct-acting antiviral therapy in chronic hepatitis C patients.Journal of the Chinese Medical Association : JCMA · 2024Article
- Management of hepatocellular carcinoma recurrence after liver surgery and thermal ablations: state of the art and future perspectives.Hepatobiliary surgery and nutrition · 2024Review
19 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
47 authors at 20 institutions in 2 countries.
Funding
Abstract
BACKGROUND &
aimsThere is controversy over the effects of direct-acting antiviral (DAA) therapies for hepatitis C virus (HCV) infection on hepatocellular carcinoma (HCC) recurrence and tumor aggressiveness. We compared HCC recurrence patterns between DAA-treated and untreated HCV-infected patients who had achieved a complete response to HCC treatment in a North American cohort.
methodsWe conducted a retrospective cohort study of patients with HCV-related HCC with a complete response to resection, local ablation, transarterial chemo- or radioembolization, or radiation therapy from January 2013 through December 2017 at 31 health systems throughout the United States and Canada. Cox regression was used to examine the association between DAA therapy and time to recurrence after a complete response, with DAA therapy analyzed as a time-varying exposure. We also estimated the association between DAA therapy and risk of early HCC recurrence (defined as 365 days after complete response).
resultsOf 793 patients with HCV-associated HCC, 304 (38.3%) received DAA therapy and 489 (61.7%) were untreated. HCC recurred in 128 DAA-treated patients (42.1%; early recurrence in 52 patients) and 288 untreated patients (58.9%; early recurrence in 227 patients). DAA therapy was not associated with HCC recurrence (hazard ratio 0.90, 95% confidence interval 0.70-1.16) or early HCC recurrence (hazard ratio 0.96, 95% confidence interval 0.70-1.34) after we adjusted for study site, age, sex, Child-Pugh score, α-fetoprotein level, tumor burden, and HCC treatment modality. In DAA-treated and untreated patients, most recurrences were within the Milan criteria (74.2% vs 78.8%; P = .23). A larger proportion of DAA-treated than untreated patients received potentially curative HCC therapy for recurrent HCC (32.0% vs 24.6%) and achieved a complete or partial response (45.3% vs 41.0%) but this did not achieve statistical significance.
conclusionIn a large cohort of North American patients with complete response to HCC treatment, DAA therapy was not associated with increased overall or early HCC recurrence. HCC recurrence patterns, including treatment response, were similar in DAA-treated and untreated patients.
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