Randomized clinical trial of long-term outcome after resection of hepatitis C virus-related hepatocellular carcinoma by postoperative interferon therapy

Abstract

Postoperative interferon therapy seems to improve the outcome after resection of HCV-related HCC.

Effects of interferon alpha treatment on recurrence and survival after complete resection or ablation of hepatocellular carcinoma: A meta‐analysis of randomized controlled trials

“…8,12,[30][31][32][33][34][35] Of the 8 studies, 3 were from the same research center 30,31,34 ; 1 of the 3, which did not provide the essential data, was excluded 34 ; in the remaining 2 studies that were by the same first author, the patients were the same, and some of the related data were also overlapping 30,31 ; moreover, each of the 2 studies 30,31 offered only part of the data that we wanted to extract, so to obtain full information, we combined the 2 studies and considered them as one. 30,31 Thus, finally 6 studies including 600 patients were included in this meta-analysis. 8,12,[30][31][32][33]35 Two studies were performed in China, 8,35 2 in Japan, 30-32 1 in 12 HCC was treated with resection before use of IFN-a in 4 studies, 8,12,30,31,35 and treated with ablation in 2 studies.…”

“…8,12,[30][31][32][33]35 Two studies were performed in China, 8,35 2 in Japan, 30-32 1 in 12 HCC was treated with resection before use of IFN-a in 4 studies, 8,12,30,31,35 and treated with ablation in 2 studies. 32,33 Resection as initial treatment for HCC was reported in 3 studies, 8,30,31,35 and resection with pre-resection ablation reported in 1 study. 12 In the 6 RCTs, all of the patients with HCC, proved mostly by pathology or histology, underwent therapies with complete resection or ablation; and IFN-a was used as adjuvant therapy initially after resection or ablation of HCC in each study.…”

“…8,12,[30][31][32][33][34][35] As far as early recurrence was concerned, some suggested that IFN-a could suppress early recurrence, 8,35 but others denied. 12,[30][31][32][33][34] As for survival, there were also discordant results reported 8,12,31,32,34,35 ; some concluded that IFN-a could improve survival, 8,31,32,34,35 but others demonstrated the opposite. 12 Considering the conflicting or inconclusive data, to reach a general conclusion, we conducted this meta-analysis with the first objective to evaluate the effect of IFN-a on overall early recurrence and survival after resection or ablation, and second to evaluate the impact of IFN-a on early recurrence and survival after liver resection that is the mainstay of treatment for primary liver cancers.…”

Does chemotherapy prevent HCV-related hepatocellular carcinoma? Cons

“…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.…”

“…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.…”