P0129 Hepatitis C patients have worse outcomes than hepatitis B patients following surgical resection for hepatocellular carcinoma both within and outside of the AASLD criteria

Abstract

Background Surgery is the mainstay of curative treatment of hepatocellular carcinoma (HCC). The outcomes of resection between patients with hepatitis B (HBV) and hepatitis C (HCV) have been described as being different but previous reports have been difficult to compare as the patients were from different centres. This study aims to determine the differences in surgical outcomes between HBV and HCV patients undergoing surgical resection for HCC at a single institution, by the same group of surgeons using the same operative approach. Methods We retrospectively studied 679 patients who underwent surgical resection for HCC by the combined HPB Service of the Singapore General Hospital and National Cancer Centre between January 2000 and February 2012. Excluded were patients with positive serology for both HBV and HCV, or negative serology for both. 412 patients fulfilled the study criteria, including 331 patients with single nodule tumours. Findings Among patients with single nodule tumours (n = 331; i.e., within the AASLD criteria), 295 were positive for HBV and 36 for HCV. Five-year disease-free survival (DFS) was significantly shorter in HCV compared with HBV patients (14.3% versus 36.3%, p = 0.008); a difference was also observed in terms of 5-year overall survival between HCV and HBV (52.0% versus 61.3%, p = 0.42). For the whole cohort (n = 412), the 5-year DFS was also lower in HCV patients than HBV (12.2% versus 33.4%, p = 0.015), and 5-year overall survival was lower in HCV patients than with HBV (45.6% versus 58.4%, p = 0.238). Interpretation DFS and overall survival after resection differ between patients with HBV- and HCV-associated HCC, with poorer outcomes observed in patients with HCV-associated HCC. A different approach in the management between the two may be considered, in light of the differences in hepatocarcinogenesis and surgical resection outcomes.