https://scholars.lib.ntu.edu.tw/handle/123456789/581743
標題: | Extrahepatic Malignancy Among Patients With Chronic Hepatitis C After Antiviral Therapy: A Real-World Nationwide Study on Taiwanese Chronic Hepatitis C Cohort (T-COACH) | 作者: | Huang C.-F. Lai H.-C. Chen C.-Y. Tseng K.-C. Kuo H.-T. Hung C.-H. Wang J.-H. Chen J.-J. Lee P.-L. Chien R.-N. Yang C.-C. Lo G.-H. Tai C.-M. Lin C.-W. JIA-HORNG KAO CHUN-JEN LIU CHEN-HUA LIU Yan S.-L. Bair M.-J. Lin C.-Y. Su W.-W. Chu C.-H. Chen C.-J. Tung S.-Y. Lo C.-C. Cheng P.-N. Chiu Y.-C. Wang C.-C. Cheng J.-S. Tsai W.-L. Lin H.-C. Huang Y.-H. Yeh M.-L. Huang J.-F. Dai C.-Y. Chuang W.-L. Tsai P.-C. Peng C.-Y. Yu M.-L. |
公開日期: | 2020 | 出版社: | NLM (Medline) | 卷: | 115 | 期: | 8 | 起(迄)頁: | 1226-1235 | 來源出版物: | The American journal of gastroenterology | 摘要: | INTRODUCTION: Chronic hepatitis C virus (HCV) infection is associated with nonhepatocellular carcinoma malignancies. We aimed to evaluate whether achieving a sustained virological response (SVR, defined as HCV RNA seronegativity throughout posttreatment 24-week follow-up) could reduce the risk of non-hepatocellular carcinoma malignancy in a real-world nationwide Taiwanese Chronic Hepatitis C Cohort (T-COACH). METHODS: A total of 10,714 patients with chronic hepatitis C who had received interferon-based therapy (8,186 SVR and 2,528 non-SVR) enrolled in T-COACH and were linked to the National Cancer Registry database for the development of 12 extrahepatic malignancies, including those with potential associations with HCV and with the top-ranking incidence in Taiwan, over a median follow-up period was 3.79 years (range, 0-16.44 years). RESULTS: During the 44,354 person-years of follow-up, 324 (3.02%) patients developed extrahepatic malignancies, without a difference between patients with and without SVR (annual incidence: 0.69% vs 0.87%, respectively). Compared with patients with SVR, patients without SVR had a significantly higher risk of gastric cancer (0.10% vs 0.03% per person-year, P = 0.004) and non-Hodgkin lymphoma (NHL) (0.08% vs 0.03% per person-year, respectively, P = 0.03). When considering death as a competing risk, non-SVR was independently associated with gastric cancer (hazard ratio [HR]/95% confidence intervals [CIs]: 3.29/1.37-7.93, P = 0.008). When patients were stratified by age, the effect of SVR in reducing gastric cancer (HR/CI: 0.30/0.11-0.83) and NHL (HR/CI: 0.28/0.09-0.85) was noted only in patients aged <65 years but not those aged >65 years. DISCUSSION: HCV eradication reduced the risk of gastric cancer and NHL, in particular among younger patients, indicating that patients with chronic hepatitis C should be treated as early as possible. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85089204146&doi=10.14309%2fajg.0000000000000606&partnerID=40&md5=7e3e403455e492d310b13d642baa6777 https://scholars.lib.ntu.edu.tw/handle/123456789/581743 |
ISSN: | 1572-0241 | DOI: | 10.14309/ajg.0000000000000606 | SDG/關鍵字: | antivirus agent; age; aged; chronic hepatitis C; cohort analysis; female; human; incidence; male; middle aged; mortality; nonhodgkin lymphoma; register; stomach tumor; survival analysis; sustained virologic response; Taiwan; Age Factors; Aged; Antiviral Agents; Cohort Studies; Female; Hepatitis C, Chronic; Humans; Incidence; Lymphoma, Non-Hodgkin; Male; Middle Aged; Registries; Stomach Neoplasms; Survival Analysis; Sustained Virologic Response; Taiwan |
顯示於: | 臨床醫學研究所 |
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