NO EVIDENCE OF A MORE AGGRESSIVE PATTERN OF HEPATOCELLULAR CARCINOMA AFTER DIRECT ACTING ANTIVI-RALS -RESULTS FROM A SINGLE CENTER OBSERVATIONAL STUDY
After great concerns were raised regarding a high incidence of hepatocellular carcinoma (HCC) after direct acting antivirals (DAAs) therapy in cirrhotic HCV patients, an avalanche of studies that debated this issue emerged, whose results highlighted also a more aggressive HCC pattern after DAAs. We aimed to assess the pattern and imaging features of HCC in patients with HCV-related liver cirrhosis after DAAs. Material and methods: This is a single-center case-controlled retrospective study in which we included consecutive patients with HCC and HCV-related liver cirrhosis admitted in our clinic between January 1st, 2016 and May 1st, 2018. Results: Sixty-nine patients with HCV-related cirrhosis and HCC were divided into 2 groups depending on the DAAs-treated or untreated status: group I included 15 patients that were previously treated with DAAs and group II included 54 naïve patients. Regarding the distribution of HCC, there were no significant differences between the two groups (73.3% of group I patients and 55.5% of group II had unicentric lesion, p=0.215). The tumor size was significantly higher in group II compared to group I, with 66.6% of patients in group I and only 29.6% of patients in group II that have a tumor size less than 3 cm (p=0.009). Supportive treatment without ablation was more frequent in group II (33.3%) than in group I (6.6%) (p=0.047). Conclusions: Our study found no evidence of a more aggressive behavior of HCC after DAAs treatment compared to naïve patients. Furthermore, the pattern of HCC after DAAs did not affect the access to curative treatment.
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