Effects of interferon alpha treatment on recurrence and survival after complete resection or ablation of hepatocellular carcinoma: a meta-analysis of randomized controlled trials.
Available literature on the benefit of interferon alpha (IFN-alpha) as adjuvant postsurgical or ablative treatment of hepatocellular carcinoma reports discordant results. By meta-analysis of the available data, we evaluated the effects of IFN-alpha on recurrence and survival after complete resection or ablation of hepatocellular carcinoma. All randomized controlled trials comparing IFN-alpha with placebo or no treatment after tumor resection or ablation were selected. Finally, 6 studies published in 2001 or later with a total of 600 patients were included in this meta-analysis. Data on postsurgical or ablative early recurrence and 1 year survival of hepatocellular carcinoma in IFN-alpha treated and untreated patients were extracted from each study. Proportions were combined, and the odds ratio (OR) with its 95% confidence interval (CI) was used as the effect size estimate. Analysis results show that IFN-alpha significantly decreased postsurgical or ablative overall early recurrence (OR = 0.62; 95% CI = 0.42-0.93; p = 0.02) and improved overall 1 year survival (OR = 3.14; 95% CI = 1.79-5.52; p < 0.0001). Subgroup analyses show that IFN-alpha decreased postsurgical early recurrence (OR = 0.58; 95% CI = 0.37-0.91; p = 0.02) and improved 1 year survival (OR = 3.19; 95% CI = 1.80-5.67; p < 0.0001) evidently. Subgroup analyses also show that IFN-alpha reduced early recurrence after resection without pre-resection ablation therapy (OR = 0.58; 95% CI = 0.37-0.91; p = 0.02) and improved 1 year survival (OR = 3.83; 95% CI = 2.01-7.27; p < 0.0001). These results suggest that IFN-alpha treatment could significantly decrease early recurrence and improve 1 year survival of patients with hepatocellular carcinoma after complete resection or ablation. The use of IFN-alpha as adjuvant postsurgical or ablative treatment seems promising but requires further study. (c) 2009 UICC.
Zhang
Chuan-Hai
CH
Graduate School of Tianjin Medical University, Tianjin, People's Republic of China.
Xu
Ge-Liang
GL
Jia
Wei-Dong
WD
Ge
Yong-Sheng
YS
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000401:mortality* / Q000601:surgery; D003131:Combined Modality Therapy; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality* / Q000601:surgery; D009367:Neoplasm Staging; D016017:Odds Ratio; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012680:Sensitivity and Specificity; D015996:Survival Rate; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D016898:Interferon-alpha