Meta-analysis: interferon improves outcomes following ablation or resection of hepatocellular carcinoma

Authors

  • A. K. Singal,

    1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA.
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  • D. H. Freeman Jr,

    1. Division of Epidemiology and Biostatistics, Department of Community Health and Preventive Medicine, University of Texas Medical Branch, Galveston, TX, USA.
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  • B. S. Anand

    1. Department of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, TX, USA.
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Dr A. K. Singal, Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-0764, USA.
E-mail: aksingal@utmb.edu

Abstract

Aliment Pharmacol Ther 2010; 32: 851–858

Summary

Background  Hepatocellular carcinoma (HCC) is third most common cause of tumour-related death in the US with hepatitis C virus (HCV) the most common aetiology. Surgical resection and tumour ablation are curative in patients who cannot be transplanted. With native liver having cirrhosis, HCC recurrence is a potential problem.

Aim  To perform a systematic review and meta-analysis of studies evaluating efficacy of IFN to prevent HCC recurrence after its curative treatment in HCV-related cirrhosis.

Methods  Ten studies (n = 645, 301 treated with IFN) on the use of IFN after resection or ablation of HCV-associated HCC were analysed.

Results  Pooled data showed benefit of IFN for HCC prevention with OR (95% CI) of 0.26 (0.15–0.45); P < 0.00001. The proportion of patients surviving at 5 years (n = 505 in 6 studies) was in favour of IFN with OR of 0.31 [(95% CI 0.21–0.46); P < 0.00001]. Data were homogeneous for HCC recurrence (χ2 12.05, P = 0.21) and survival (χ2 6.93, P = 0.44). The benefit of IFN was stronger with sustained virological response compared with nonresponders for HCC recurrence [0.19 (0.06–0.60); P = 0.005] and survival [0.31 (0.11–0.90); P = 0.03].

Conclusion  Interferon treatment after curative resection or ablation of HCC in HCV-related cirrhotics prevents HCC recurrence and improves survival.

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