title: Effect of interferon therapy on first and second recurrence after resection of hepatitis C virus-related hepatocellular carcinoma.
abstract: OBJECTIVE
  Several investigators have shown that interferon (IFN) therapy can suppress the recurrence of hepatocellular carcinoma (HCC) after curative treatment. We investigated the effect of IFN therapy on the first and second HCC recurrence following hepatic resection of hepatitis C virus (HCV)-related HCC.
  
  
  METHODS
  Subjects included 166 patients who had undergone curative resection for a single HCV-related HCC. We analyzed the outcome after initial hepatic resection and risk factors of a second HCC recurrence following treatment for the first HCC recurrence.
  
  
  RESULTS
  Using multivariate analysis, a non-sustained virological response (non-SVR) was significantly associated with a high incidence of first HCC recurrence. The rate of second HCC recurrence tended to be higher in the non-SVR group than in the SVR group. In the patients with recurrence of multiple tumors or who received non-curative treatment for recurrent HCC, the second HCC recurrence rates were significantly higher. Multivariate analysis demonstrated that non-curative treatment for first HCC recurrence was an independent risk factor for a second HCC recurrence. Among the patients who received curative treatment for their first HCC recurrence, the rates of second recurrence were significantly higher in the non-SVR group than in the SVR group. Multivariate analysis also revealed that SVR was independently associated with prevention of a second HCC recurrence.
  
  
  CONCLUSIONS
  These results suggest that on first HCC recurrence, a curative treatment should be considered in order to prevent a second recurrence if possible. In addition, IFN therapy contributes to improved prognosis after curative treatment, even in patients with recurrent HCC.
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine             Department of Hepato-Biliary-Pancreatic Surgery, Osaka City General Hospital             Department of Surgery, Osaka City Juso Hospital, Osaka, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sakae
authors.forename: Shoji
authors.initials: S
authors.lastname: Kubo
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Takemura
authors.forename: Chikaharu
authors.initials: C
authors.lastname: Sakata
authors.forename: Takahiro
authors.initials: T
authors.lastname: Uenishi
authors.forename: Shintaro
authors.initials: S
authors.lastname: Kodai
authors.forename: Hiroji
authors.initials: H
authors.lastname: Shinkawa
authors.forename: Yorihisa
authors.initials: Y
authors.lastname: Urata
authors.forename: Kazunori
authors.initials: K
authors.lastname: Ohata
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Kaneda
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Nishioka
authors.forename: Akinori
authors.initials: A
authors.lastname: Nozawa
authors.forename: Shigefumi
authors.initials: S
authors.lastname: Suehiro