Postoperative low hepatitis C virus load predicts long‐term outcomes after hepatectomy for hepatocellular carcinoma

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Background Preoperative hepatitis C virus (HCV) viral load is known to predict long‐term outcomes after hepatectomy for HCV‐related hepatocellular carcinoma (HCC). This study sought to examine the hypothesis that postoperative and preoperative HCV viral‐load have similar prognostic implications, as well as determine a target viral‐load that will improve long‐term postoperative outcomes. Method One hundred and eighty‐one patients who underwent curative hepatectomy for HCV‐related HCC were divided into five groups according to time‐weighted average viral load. The cumulative‐recurrence curves of the five groups were compared to identify prognostic trends. The optimal cut‐off viral load value related to recurrence was also investigated. Results The five cumulative‐recurrence curves were separated into two clusters according to viral load. Patients with a negative viral load had comparable recurrence curves to patients with the lowest viral‐load (P = 0.907); both of these patient groups had more favorable outcomes than patients with a viral load categorized in the other groups (all P < 0.050). The optimal cut‐off based on maximum HR method (> or ≤4.0 log10 IU/mL) was a strong prognostic indicator of recurrence in multivariate analysis (HR 3.09; 95%CI 1.96‐5.04; P < 0.001). Conclusion Postoperative HCV viral load correlated with long‐term surgical outcomes. A low viral load (≤4.0 log10 IU/mL) independently predicted better long‐term outcomes.