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

Alimentary Pharmacology & Therapeutics
Early View (Articles online in advance of print)
Published Online: 26 Jul 2010
Journal compilation © 2010 Blackwell Publishing Ltd

A. K. Singal*, D. H. Freeman Jr † & B. S. Anand ‡

*Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA.

† Division of Epidemiology and Biostatistics, Department of Community Health and Preventive Medicine, University of Texas Medical Branch, Galveston, TX, USA.

‡ Department of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, TX, USA.

Correspondence to 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

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.

Publication data Submitted 24 April 2010 First decision 20 May 2010 Resubmitted 30 June 2010 Accepted 1 July 2010

DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1365-2036.2010.04414.x About DOI
 
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