Mitsuo Miyazawa, MD, FACS1, Masayasu Aikawa, MD2, Katsuya Okada, MD2, Yukihiro Watanabe, MD2, Kojun Okamoto, MD2. 1Teikyo University Mizonokuchi Hospital, 2Saitama Medical University International Medical Center
Backgroud and Aim: Direct acting antivirals (DAAs), oral drugs for hepatitis C, became available for use from September 2014 in Japan, making hepatitis C a curable disease. We evaluated laparoscopic liver resection (LLR) as treatment before DAA administration based on the short-term results of patients with HCC with hepatitis C who had undergone laparoscopic HCC resection, followed by the administration of DAA at our hospita
Method: At our hospital, 206 patients underwent LLR between April 2008 and March 2016, and 144 had HCC. Of these patients, we studied 90 with a diagnosis of hepatitis C virus-related HCC (DAA given to 15 patients; 7 men, 8 women; 14 with genotype 1b, 1 with 2a; IFN ineligible or not given in 5, relapse after pretreatment in 7, non-response to pretreatment in 3; 11 with hepatic damage level A, 4 with level B, 0 with level C). In order to examine the role of LLR in multidisciplinary therapy (including the administration of DAA) for patients with HCC with hepatitis C, we studied 15 patients receiving DAA focusing on the clinical course before administration, LLR perioperative course, and the clinical course after the administration of DAA.
Results: The surgical procedures in 15 patients receiving DAA were laparoscopic partial hepatectomy in 13 and lateral segmentectomy in 2. Blood loss was 52.5 (0-208) mL. The operative time was 207 (127-390) minutes. The duration of postoperative hospitalization was 7.6 (3-13) days. One patient had a postoperative complication (bile leakage, which resolved with conservative treatment). There was no change in the level of liver damage in any of the patients one month after surgery. The administration of DAA was completed in 15 patients. At present, these 15 patients continue to have sustained virological response (SVR). One patient, to date, has developed recurrence.
Conclusion and discussion: We administered DAA to 15 patients with HCC with hepatitis C following LLR. All 15 completed the treatment with DAA and continue to have SVR at present. In this era of DAA, LLR is considered to be a treatment that can achieve switching to DAA therapy while preserving hepatic functional reserve as a multidisciplinary treatment approach for HCC with hepatitis C.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 77432
Program Number: P457
Presentation Session: Poster (Non CME)
Presentation Type: Poster