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Hypovascular tumors developed into hepatocellular carcinoma at a high rate despite the elimination of hepatitis C virus by direct-acting antivirals.

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Title: Hypovascular tumors developed into hepatocellular carcinoma at a high rate despite the elimination of hepatitis C virus by direct-acting antivirals.
Authors: Tabu, Kazuaki, Mawatari, Seiichi, Oda, Kohei, Kumagai, Kotaro, Inada, Yukiko, Uto, Hirofumi, Saisyoji, Akiko, Hiramine, Yasunari, Hashiguchi, Masafumi, Tamai, Tsutomu, Hori, Takeshi, Fujisaki, Kunio, Imanaka, Dai, Kure, Takeshi, Taniyama, Ohki, Toyodome, Ai, Ijuin, Sho, Sakae, Haruka, Sakurai, Kazuhiro, Moriuchi, Akihiro
Source: PLoS ONE; 8/13/2020, Vol. 15 Issue 8, p1-14, 14p
Subject Terms: HEPATITIS C, HEPATITIS C virus, HEPATOCELLULAR carcinoma, CONTRAST-enhanced magnetic resonance imaging, TUMOR growth, TUMORS
Abstract: Background and aims: Direct-acting antivirals (DAAs) against hepatitis C virus (HCV) exert high anti-HCV activity and are expected to show anti-inflammatory effects associated with HCV elimination. Furthermore, hepatocellular carcinoma (HCC) is known to dedifferentiate from hypovascular tumors, such as dysplastic nodules or well-differentiated HCC, to hypervascular tumors. We therefore explored whether or not DAAs can suppress the growth and hypervascularization of hypovascular tumors. Methods: We enrolled 481 patients with HCV genotype 1 infection who were treated with Daclatasvir and Asunaprevir therapy. Of these, 29 patients had 33 hypovascular tumors, which were confirmed by contrast-enhanced MRI or CT before therapy. We prospectively analyzed the cumulative incidence of HCC, i.e. the growth or hypervascularization of hypovascular tumors, and compared the HCC development rates between patients with hypovascular tumors and those without any tumors. Results: The mean size of the hypovascular tumors was 11.3 mm. Twenty seven of 29 patients who achieved an SVR had 31 nodules, 19 of 31 nodules (61.3%) showed tumor growth or hypervascularization, and 12 (38.7%) nodules showed no change or improvement. The cumulative incidence rates of tumor growth or hypervascularization were 19.4% at 1 year, 36.0% at 2 years, 56.6% at 3 years, and 65.3% at 4 years. Among the patients who achieved a sustained virologic response, the cumulative HCC development rates of patients with hypovascular tumors was significantly higher than in those without any tumors. A Cox proportional hazard analysis showed that a history of HCC therapy, the presence of a hypovascular tumor, and AFP >4.6 ng/mL at the end of treatment were independent risk factors for HCC development. Conclusion: Hypovascular tumors developed into HCC at a high rate despite the elimination of HCV by DAAs. As patients with hypovascular tumors were shown to have a high risk of HCC development, they should undergo strict HCC surveillance. [ABSTRACT FROM AUTHOR]
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  Data: Hypovascular tumors developed into hepatocellular carcinoma at a high rate despite the elimination of hepatitis C virus by direct-acting antivirals.
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  Data: <searchLink fieldCode="AR" term="%22Tabu%2C+Kazuaki%22">Tabu, Kazuaki</searchLink><br /><searchLink fieldCode="AR" term="%22Mawatari%2C+Seiichi%22">Mawatari, Seiichi</searchLink><br /><searchLink fieldCode="AR" term="%22Oda%2C+Kohei%22">Oda, Kohei</searchLink><br /><searchLink fieldCode="AR" term="%22Kumagai%2C+Kotaro%22">Kumagai, Kotaro</searchLink><br /><searchLink fieldCode="AR" term="%22Inada%2C+Yukiko%22">Inada, Yukiko</searchLink><br /><searchLink fieldCode="AR" term="%22Uto%2C+Hirofumi%22">Uto, Hirofumi</searchLink><br /><searchLink fieldCode="AR" term="%22Saisyoji%2C+Akiko%22">Saisyoji, Akiko</searchLink><br /><searchLink fieldCode="AR" term="%22Hiramine%2C+Yasunari%22">Hiramine, Yasunari</searchLink><br /><searchLink fieldCode="AR" term="%22Hashiguchi%2C+Masafumi%22">Hashiguchi, Masafumi</searchLink><br /><searchLink fieldCode="AR" term="%22Tamai%2C+Tsutomu%22">Tamai, Tsutomu</searchLink><br /><searchLink fieldCode="AR" term="%22Hori%2C+Takeshi%22">Hori, Takeshi</searchLink><br /><searchLink fieldCode="AR" term="%22Fujisaki%2C+Kunio%22">Fujisaki, Kunio</searchLink><br /><searchLink fieldCode="AR" term="%22Imanaka%2C+Dai%22">Imanaka, Dai</searchLink><br /><searchLink fieldCode="AR" term="%22Kure%2C+Takeshi%22">Kure, Takeshi</searchLink><br /><searchLink fieldCode="AR" term="%22Taniyama%2C+Ohki%22">Taniyama, Ohki</searchLink><br /><searchLink fieldCode="AR" term="%22Toyodome%2C+Ai%22">Toyodome, Ai</searchLink><br /><searchLink fieldCode="AR" term="%22Ijuin%2C+Sho%22">Ijuin, Sho</searchLink><br /><searchLink fieldCode="AR" term="%22Sakae%2C+Haruka%22">Sakae, Haruka</searchLink><br /><searchLink fieldCode="AR" term="%22Sakurai%2C+Kazuhiro%22">Sakurai, Kazuhiro</searchLink><br /><searchLink fieldCode="AR" term="%22Moriuchi%2C+Akihiro%22">Moriuchi, Akihiro</searchLink>
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  Data: PLoS ONE; 8/13/2020, Vol. 15 Issue 8, p1-14, 14p
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  Data: <searchLink fieldCode="DE" term="%22HEPATITIS+C%22">HEPATITIS C</searchLink><br /><searchLink fieldCode="DE" term="%22HEPATITIS+C+virus%22">HEPATITIS C virus</searchLink><br /><searchLink fieldCode="DE" term="%22HEPATOCELLULAR+carcinoma%22">HEPATOCELLULAR carcinoma</searchLink><br /><searchLink fieldCode="DE" term="%22CONTRAST-enhanced+magnetic+resonance+imaging%22">CONTRAST-enhanced magnetic resonance imaging</searchLink><br /><searchLink fieldCode="DE" term="%22TUMOR+growth%22">TUMOR growth</searchLink><br /><searchLink fieldCode="DE" term="%22TUMORS%22">TUMORS</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background and aims: Direct-acting antivirals (DAAs) against hepatitis C virus (HCV) exert high anti-HCV activity and are expected to show anti-inflammatory effects associated with HCV elimination. Furthermore, hepatocellular carcinoma (HCC) is known to dedifferentiate from hypovascular tumors, such as dysplastic nodules or well-differentiated HCC, to hypervascular tumors. We therefore explored whether or not DAAs can suppress the growth and hypervascularization of hypovascular tumors. Methods: We enrolled 481 patients with HCV genotype 1 infection who were treated with Daclatasvir and Asunaprevir therapy. Of these, 29 patients had 33 hypovascular tumors, which were confirmed by contrast-enhanced MRI or CT before therapy. We prospectively analyzed the cumulative incidence of HCC, i.e. the growth or hypervascularization of hypovascular tumors, and compared the HCC development rates between patients with hypovascular tumors and those without any tumors. Results: The mean size of the hypovascular tumors was 11.3 mm. Twenty seven of 29 patients who achieved an SVR had 31 nodules, 19 of 31 nodules (61.3%) showed tumor growth or hypervascularization, and 12 (38.7%) nodules showed no change or improvement. The cumulative incidence rates of tumor growth or hypervascularization were 19.4% at 1 year, 36.0% at 2 years, 56.6% at 3 years, and 65.3% at 4 years. Among the patients who achieved a sustained virologic response, the cumulative HCC development rates of patients with hypovascular tumors was significantly higher than in those without any tumors. A Cox proportional hazard analysis showed that a history of HCC therapy, the presence of a hypovascular tumor, and AFP >4.6 ng/mL at the end of treatment were independent risk factors for HCC development. Conclusion: Hypovascular tumors developed into HCC at a high rate despite the elimination of HCV by DAAs. As patients with hypovascular tumors were shown to have a high risk of HCC development, they should undergo strict HCC surveillance. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label:
  Group: Ab
  Data: <i>Copyright of PLoS ONE is the property of Public Library of Science and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Text: English
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