Obesity and recurrence‐free survival in patients with hepatocellular carcinoma after achieving sustained virological response to interferon therapy for chronic hepatitis C

Abstract

AimSome patients who achieve a sustained virological response (SVR) to interferon (IFN) treatment for chronic hepatitis C prior to hepatic resection for hepatocellular carcinoma (HCC) experience postoperative recurrence. This study investigated the relationship between obesity and postoperative HCC recurrence in SVR patients.MethodsFifty‐nine patients who had achieved SVR before hepatic resection were evaluated. Patients had a solitary tumor ≤5 cm in diameter or ≤3 lesions each ≤3 cm in size with no macroscopic vascular invasion (Milan criteria). Patient characteristics potentially associated with recurrence risk were investigated.ResultsThree‐, 5‐, and 7‐year recurrence‐free survival after surgery were 65%, 44%, and 41%, respectively. Univariate analysis showed that obesity (P < .01), hypertension (P = .038), and non‐anatomical resection (P = .022) were significantly associated with a lower recurrence‐free survival rate. In a multivariate analysis, obesity (hazard ratio, 2.8; 95% confidence interval [CI] 1.3‐6.1; P < .01) and non‐anatomical resection (hazard ratio, 2.7; 95% CI 1.1‐6.2; P = .025) were independently associated with postoperative recurrence. Three‐, 5‐, and 7‐year overall survival rates after surgery were 100%, 80%, and 64% in obese patients and 100%, 92%, and 82% in non‐obese patients, respectively (P = .014). However, other variables showed no significant difference in the overall survival rate.ConclusionsObesity and non‐anatomical resection were independent risk factors for HCC recurrence after hepatic resection and successful IFN therapy. Obesity is an important clinical problem to consider to improve postoperative outcomes in such patients.

Obesity is a risk factor for intrahepatic cholangiocarcinoma progression associated with alterations of metabolic activity and immune status

“…Our group and other researchers previously reported that obesity is associated with poor prognosis in HCC 25 – 27 . Thus, elevated BMI has been considered a predictive risk factor in several cancers, including HCC.…”

Liver steatosis is a major predictor of poor outcomes in chronic hepatitis C patients with sustained virological response

“…Liver steatosis and the metabolic syndrome per se are in close link with an increased risk of mortality as well as hepatic and extra‐hepatic malignancies . Furthermore, obesity was found to be an independent risk factor for HCC recurrence in patients who achieved SVR with interferon‐based regimens regardless of baseline liver fibrosis grade or the presence of cirrhosis . These previous findings, combined with our real‐life data regarding HCC occurrence in the DAA era, highlight the importance of LS as a major risk factor for poor outcome and warrant a special consideration of screening and follow‐up in this specific population.…”

Viral elimination is essential for improving surgical outcomes of hepatitis C virus‐related hepatocellular carcinoma: Multicenter retrospective analysis

“…3 To improve the survival of these patients, curative treatment for HCC is essential. Previous reports have demonstrated the possible favorable effect of SVR before hepatectomy on surgical outcomes [4][5][6][7][8][9][10] ; however, the true impact of SVR is not well-documented for various reasons.…”