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Artículo
Hepatocellular carcinoma recurrence after direct-acting antiviral therapy: An individual patient data meta-analysis
dc.creator | Sapena, Victor | es |
dc.creator | Enea, Marco | es |
dc.creator | Torres, Ferran | es |
dc.creator | Celsa, Ciro | es |
dc.creator | Ríos, José J. | es |
dc.creator | Rizzo, Giacomo Emanuele Maria | es |
dc.creator | Nahon, Pierre | es |
dc.creator | Merchante Gutiérrez, Nicolás | es |
dc.creator | Reig, Maria | es |
dc.date.accessioned | 2022-12-01T15:37:00Z | |
dc.date.available | 2022-12-01T15:37:00Z | |
dc.date.issued | 2022 | |
dc.identifier.citation | Sapena, V., Enea, M., Torres, F., Celsa, C., Ríos, J.J., Rizzo, G.E.M.,...,Reig, M. (2022). Hepatocellular carcinoma recurrence after direct-acting antiviral therapy: An individual patient data meta-analysis. Gut, 71 (3), 593-604. https://doi.org/10.1136/gutjnl-2020-323663. | |
dc.identifier.issn | 0017-5749 | es |
dc.identifier.issn | 1468-3288 | es |
dc.identifier.uri | https://hdl.handle.net/11441/140039 | |
dc.description.abstract | Abstract Objective The benefit of direct-acting antivirals (DAAs) against HCV following successful treatment of hepatocellular carcinoma (HCC) remains controversial. This meta-analysis of individual patient data assessed HCC recurrence risk following DAA administration. Design We pooled the data of 977 consecutive patients from 21 studies of HCV-related cirrhosis and HCC, who achieved complete radiological response after surgical/locoregional treatments and received DAAs (DAA group). Recurrence or death risk was expressed as HCC recurrence or death per 100 person-years (100PY). Propensity score-matched patients from the ITA.LI.CA. cohort (n=328) served as DAA-unexposed controls (no-DAA group). Risk factors for HCC recurrence were identified using random-effects Poisson. Results Recurrence rate and death risk per 100PY in DAA-treated patients were 20 (95% CI 13.9 to 29.8, I2=74.6%) and 5.7 (2.5 to 15.3, I2=54.3), respectively. Predictive factors for recurrence were alpha-fetoprotein logarithm (relative risk (RR)=1.11, 95% CI 1.03 to 1.19; p=0.01, per 1 log of ng/mL), HCC recurrence history pre-DAA initiation (RR=1.11, 95% CI 1.07 to 1.16; p<0.001), performance status (2 vs 0, RR=4.35, 95% CI 1.54 to 11.11; 2 vs 1, RR=3.7, 95% CI 1.3 to 11.11; p=0.01) and tumour burden pre-HCC treatment (multifocal vs solitary nodule, RR=1.75, 95% CI 1.25 to 2.43; p<0.001). No significant difference was observed in RR between the DAA-exposed and DAA-unexposed groups in propensity score-matched patients (RR=0.64, 95% CI 0.37 to 1.1; p=0.1). Conclusion Effects of DAA exposure on HCC recurrence risk remain inconclusive. Active clinical and radiological follow-up of patients with HCC after HCV eradication with DAA is justified. | es |
dc.format | application/pdf | es |
dc.format.extent | 11 p. | es |
dc.language.iso | eng | es |
dc.publisher | British Society of Gastroenterology (BSG) | es |
dc.relation.ispartof | Gut, 71 (3), 593-604. | |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 Internacional | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | * |
dc.subject | Hepatocellular carcinoma | es |
dc.subject | Antiviral therapy | es |
dc.subject | Individual patient | es |
dc.subject | Meta-analysis | es |
dc.title | Hepatocellular carcinoma recurrence after direct-acting antiviral therapy: An individual patient data meta-analysis | es |
dc.type | info:eu-repo/semantics/article | es |
dc.type.version | info:eu-repo/semantics/publishedVersion | es |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | es |
dc.contributor.affiliation | Universidad de Sevilla. Departamento de Medicina | es |
dc.relation.publisherversion | https://gut.bmj.com/content/71/3/593 | es |
dc.identifier.doi | 10.1136/gutjnl-2020-323663 | es |
dc.journaltitle | Gut | es |
dc.publication.volumen | 71 | es |
dc.publication.issue | 3 | es |
dc.publication.initialPage | 593 | es |
dc.publication.endPage | 604 | es |