1Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
BACKGROUND AND AIMS:
Treatment strategies for hepatocellular carcinoma have been advanced. The aim of this study was to compare the change of the prognosis between hepatitis B-related hepatocellular carcinoma (B-HCC) and hepatitis C-related hepatocellular carcinoma (C-HCC) in the last two decade.
We enrolled 166 B-HCC patients who underwent percutaneous ablation between 1990 and 2009. Patients were divided into three groups according to the treatment time period: 1990-1995 (cohort 1, n=19), 1996-2002 (cohort 2, n=49), 2003-2009 (cohort 3, n=98). We enrolled 1,219 C-HCC patients who underwent percutaneous ablation during the same period (n=190, 413 and 616, respectively.). Interferon and nucleos(t)ide analog use was investigated. Prognosis was evaluated for each cohort using the Kaplan-Meier method and a multivariate Cox proportional hazard regression model.
Two (11%), twenty-four (49%) and eighty (82%) B-HCC patients received nucleos(t)ide analogs during the follow-up period in cohorts 1-3, respectively. Among them 1, 18, and 62 patients achieved viral remission, respectively. Thirty-four (18%), thirty-five (8%), and eighty-four (14%) C-HCC patients received interferon therapy, respectively. The 5-year B-HCC (p<0.001) survival rates were 52.6, 61.1, and 81.6% for cohorts 1-3, respectively. Whereas, the survival rates were 55.6, 58.8, and 61.1% for C-HCC (p=0.12), respectively. The B-HCC prognosis improved dramatically (hazard ratio [HR] of 0.30 for cohort 3 vs. 1; 95% CI, 0.16-0.58; p<0.001) over time, whereas the prognosis of C-HCC improved moderately (HR 0.75; 95% CI, 0.61-0.93; p=0.01).
The prognosis of B-HCC has improved dramatically over time, whereas that of C-HCC has improved moderately.