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Invited Commentary
October 17, 2018

Combining Antiviral Therapy With Tumor Resection as Optimal Treatment for Hepatocellular Carcinoma

Author Affiliations
  • 1City of Hope Medical Center, Duarte, California
JAMA Surg. 2018;153(10):e182728. doi:10.1001/jamasurg.2018.2728

Optimal care for hepatitis virus–related hepatocellular carcinoma (HCC) would include eradication of tumor and elimination of hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. Accomplishing these goals could prevent deaths from cancer or cirrhosis and reduce the likelihood of viral transmission. Tremendous progress has recently been achieved for tumor and antiviral therapies. Long-term survival from cancer was previously a rarity. Now, partial hepatectomy, liver transplant, or tumor ablation provide 5-year survival rates of 45% to 80%.1 Direct-acting antivirals (DAA) can now prevent cirrhosis in patients with HBV and can produce cures in patients with HCV2 for most patients and with little morbidity. Data are also accumulating that successful antiviral treatment reduces recurrence of cancer. In this issue of JAMA Surgery, Li et al3 examined a cohort of 2552 patients with resection of HCC and demonstrated that preresection (>90 days) effective treatment for HBV is associated with a lower tumor vascular invasion and decreased recurrence.

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