Long-term interferon maintenance therapy improves survival in patients with HCV-related hepatocellular carcinoma after curative radiofrequency ablation. A matched case-control study.
OBJECTIVE
To assess whether low-dose, long-term maintenance interferon (IFN) therapy inhibits recurrence after complete ablation of hepatocellular carcinoma (HCC) and improves patient survival.


METHODS
From June 1999 through May 2006, a total of 127 HCC cases that met the requirements of both tumor diameter 3 cm or less, and number of tumors three or fewer, were curatively treated by radiofrequency ablation therapy (RFA). Among them, 43 patients received three million IU of IFN-alpha2b twice per week or pegylated IFN-alpha2a 90 microg once per week or once per 2 weeks without discontinuation (IFN maintenance group). The remaining 84 patients, whose sex, age, and platelet counts were randomly matched to those of the IFN maintenance group, did not receive IFN treatment (control group).


RESULTS
Cumulative first, second, and third recurrence rates were significantly reduced in the IFN maintenance group compared with the control group by Kaplan-Meier estimate. The 5-year survival rate was 66% for the control group and 83% for the IFN maintenance group (p = 0.004). Multivariate analysis using the Cox proportional hazards model identified IFN maintenance therapy as an independent risk factor for survival, and the risk ratio was 0.21 (95% CI: 0.05-0.73). In conclusion, low-dose, long-term maintenance IFN therapy after curative RFA therapy of HCC significantly inhibits recurrence, and consequently improves patient survival.
Kudo
Masatoshi
M
Department of Gastroenterology and Hepatology, Kinki University School of Medicine, Osaka, Japan. m-kudo@med.kindai.ac.jp
Sakaguchi
Yasuhiro
Y
Chung
Hobyung
H
Hatanaka
Kinuyo
K
Hagiwara
Satoru
S
Ishikawa
Emi
E
Takahashi
Shunsuke
S
Kitai
Satoshi
S
Inoue
Tatsuo
T
Minami
Yasunori
Y
Ueshima
Kazuomi
K
D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D000998:Antiviral Agents / Q000008:administration & dosage*; D014408:Biomarkers, Tumor / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology / Q000601:surgery / Q000821:virology; D016022:Case-Control Studies; D017115:Catheter Ablation; D005260:Female; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D007372:Interferons / Q000008:administration & dosage*; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology / Q000601:surgery / Q000821:virology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D016017:Odds Ratio; D016016:Proportional Hazards Models; D012307:Risk Factors; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D000998:Antiviral Agents; D014408:Biomarkers, Tumor; D007372:Interferons