Interferon Therapy after Tumor Ablation Improves Prognosis in Patients with Hepatocellular Carcinoma Associated with Hepatitis C Virus

Shiratori, Yasushi; Shiina, Shuichiro; Teratani, Takuma; Imamura, Masatoshi; Obi, Shuntaro; Sato, Shinpei; Koike, Yukihiro; Yoshida, Haruhiko; Omata, Masao

doi:10.7326/0003-4819-138-4-200302180-00008

Cited by 274 publications

(262 citation statements)

References 38 publications

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“…Other RCTs, also performed in Japan and Taiwan, failed to find a significant delay in the first recurrence with IFN therapy, but the second or third recurrence was significantly reduced especially in sustained responders and the overall survival was improved [401,402]. Another RCT in Italy did not detect effects of IFN therapy on early recurrence but late recurrence, with more than 2 years of interval, seemed to be reduced among IFN responders [403].…”

Section: Tertiary Prevention Of Hcv-related Hccmentioning

confidence: 94%

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

et al. 2010

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Introduction The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on the management of hepatocellular carcinoma (HCC) in December 2008 to develop consensus recommendations. Methods The working party consisted of expert hepatologist, hepatobiliary surgeon, radiologist, and oncologist from Asian-Pacific region, who were requested to make drafts prior to the consensus meeting held at Bali, Indonesia on 4 December 2008. The quality of existing evidence and strength of recommendations were ranked from 1 (highest) to 5 (lowest) and from A (strongest) to D (weakest), respectively, according to the Oxford system of evidence-based approach for developing the consensus statements. 123Hepatol Int (2010) 4: 439-474 DOI 10.1007/s12072-010-9165-7 Results Participants of the consensus meeting assessed the quality of cited studies and assigned grades to the recommendation statements. Finalized recommendations were presented at the fourth APASL single topic conference on viral-related HCC at Bali, Indonesia and approved by the participants of the conference.

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Section: Tertiary Prevention Of Hcv-related Hccmentioning

confidence: 94%

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

et al. 2010

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“…Since the first RCT of IFN adjuvant therapy appeared in 2000 [45], four other RCTs have been published [46][47][48][49]. Studies have indicated that IFN decreases the rate of HCC recurrence, and the results of our meta-analysis, totalling 196 patients, consistently show a statistically significant benefit on HCC recurrence.…”

Section: Interferonmentioning

confidence: 55%

“…Therefore, all these data underscore, from a practical point of view, the need for adjuvant therapy (tertiary prevention) in the effort to prolong survival and reduce recurrence rates. In the past, different anticancer agents have been evaluated for tertiary prevention of HCC recurrence, including retinoids [42], intra-arterial I-131 [43], adoptive immunotherapy [44], and finally IFN [45][46][47][48][49]. Recently, sorafenib, an oral multi-kinase inhibitor targeting both tumor cells and the tumor vasculature is being evaluated in the setting of tertiary chemoprevention.…”

Section: Tertiary Chemopreventionmentioning

confidence: 99%

Does chemotherapy prevent HCV-related hepatocellular carcinoma? Cons

Craxı̀¹,

Cammà²

2010

Digestive and Liver Disease

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The accuracy and the reliability of well-recognized clinical, virologic, histologic, and molecular risk factors for hepatocellular carcinoma (HCC) are still insufficient. Thus, accurate risk prediction of cancer development in individual patients with the aim of selecting high risk cohorts of patients for HCC chemoprevention programs remains an elusive goal. Future directions in chemoprevention of HCC will be in the development of molecular risk models and of new chemopreventive agents. Studies examining multiple genes and proteins (genomics and proteomics) in the same HCCs will be required to evaluate this possibility thoroughly. A strategy aiming at preventing chronic liver disease of any etiology (HCV and HBV infection, alcohol, obesity, others) may be required to prevent HCC in low and intermediate incidence areas, and hence, worldwide. In the setting of secondary chemoprevention, literature data pooling suggests a slight preventive effect of interferon (IFN) on HCC development in patients with HCV-related cirrhosis. The magnitude of this effect is low, and the observed benefit might be due to spurious associations. The preventive effect is limited to sustained virological responders to IFN. So, there is no sound evidence to support a recommendation for widespread use of IFN to prevent HCC in HCV-related cirrhosis. In the setting of tertiary chemoprevention, the risk of recurrence of HCC may be reduced by IFN treatment in selected patient populations. Further large-scale multicenter randomized controlled trials may prove useful to evaluate the benefit on overall survival.

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“…Promising results have been reported by adaptive immunotherapy (Takayama et al, 2000) and selective radiotherapy (Lau et al, 1999), which ideally would act on unrecognized disseminated tumor nests. Similarly, retinoid administration (Muto et al, 1996) and interferon therapy (Shiratori et al, 2003) have also been suggested to be active in preventing metachronic HCC. Unfortunately, none of the available data suffice to incorporate any of these options in conventional clinical practice (Bruix and Sherman, 2005).…”

Section: Surgical Resectionmentioning

confidence: 99%

New aspects of diagnosis and therapy of hepatocellular carcinoma

et al. 2006

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Hepatocellular carcinoma is one of the major cancer killers. It affects patients with chronic liver disease who have established cirrhosis, and currently is the most frequent cause of death in these patients. The main risk factors for its development are hepatitis B and C virus infection, alcoholism and aflatoxin intake. If acquistion of risk factors is not prevented and cirrhosis is established, the sole option to improve survival is to detect the tumor at an early stage when effective therapy may be indicated. Early detection plans should be based on hepatic ultrasonography every 6 months, whereas determination of tumor markers is not efficient. Upon detection of a hepatic nodule, there is a need to establish unequivocal diagnosis, either through biopsy or through the application of non-invasive criteria based on the specific radiology appearance of the tumor: fast arterial uptake of contrast followed by venous washout. Effective treatment for liver cancer includes surgical resection, liver transplantation and percutaneous ablation. These options provide a high rate of complete responses and are assumed to improve survival that should exceed 50% at 5 years. If the tumor is diagnosed at an advanced stage, the sole option that improves survival is transarterial chemoembolization. Ongoing research should further advance the time at diagnosis and identify new and effective options targeting molecular pathways governing tumor progression.

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Interferon Therapy after Tumor Ablation Improves Prognosis in Patients with Hepatocellular Carcinoma Associated with Hepatitis C Virus

Abstract: After tumor ablation by ethanol injection, interferon therapy may enhance patient survival in selected patients with chronic hepatitis C.

Cited by 274 publications

References 38 publications

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

Does chemotherapy prevent HCV-related hepatocellular carcinoma? Cons

New aspects of diagnosis and therapy of hepatocellular carcinoma

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