Sustained viral response prolonged survival of patients with C-viral hepatocellular carcinoma.
BACKGROUND
We conducted this retrospective study to evaluate the position of interferon therapy in the curative treatment of hepatitis C virus-associated hepatocellular carcinoma (HCC).


METHODS
We compared overall and recurrence-free survival rates between 191 patients who received interferon therapy before HCC development (15 with sustained virologic response (SVR)), 53 who received interferon therapy after HCC ablation (17 with SVR), and 399 HCC patients with Child-Pugh class A liver function who did not receive interferon (controls).


RESULTS
The overall survival rate in the controls was 82.4%, 53.2%, and 28.3% at 3, 6, and 9 years, respectively, whereas that in patients who developed HCC after achieving SVR was 93.3%, 93.3%, and 93.3%; those with HCC after non-SVR, 87.8%, 56.5%, and 35.8%; SVR after HCC, 100%, 87.5%, and 59.7%; and non-SVR after HCC, 94.3%, 70.9%, and 53.2%. Cox proportional hazard regression analysis revealed that the risk of death was significantly reduced in patients with HCC after SVR and those with SVR after HCC, with a risk ratio of 0.124 (95% confidence interval (95% CI): 0.017-0.890, P = 0.0378) and 0.388 (95% CI: 0.169-0.887, P = 0.0250), respectively, compared with the controls. Improved survival was attributable mainly to sustained liver function among patients with SVR, and recurrence-free survival did not differ significantly.


CONCLUSIONS
Interferon therapies before and after HCC development were both significantly associated with prolonged survival when SVR was achieved.
Akamatsu
Masatoshi
M
Department of Gastroenterology, The University of Tokyo Hospital, Tokyo, Japan. makamatsu-gi@umin.ac.jp
Yoshida
Haruhiko
H
Shiina
Shuichiro
S
Teratani
Takuma
T
Obi
Shuntaro
S
Tateishi
Ryousuke
R
Mine
Norio
N
Kondo
Yuji
Y
Kawabe
Takao
T
Omata
Masao
M
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000401:mortality* / Q000821:virology; D016022:Case-Control Studies; D018572:Disease-Free Survival; D004341:Drug Evaluation; D005260:Female; D016174:Hepacivirus; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
D007372:Interferons