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

• Published in: Alimentary pharmacology & therapeutics Vol. 32; no. 7; pp. 851 - 858
• Main Authors: Singal, A. K., Freeman Jr, D. H., Anand, B. S.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-10-2010; Blackwell
• Subjects: Antiviral Agents - therapeutic use; Biological and medical sciences; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - surgery; Digestive system; Gastroenterology. Liver. Pancreas. Abdomen; Hepatectomy; Hepatitis C virus; Hepatitis C, Chronic - complications; Hepatitis C, Chronic - drug therapy; Humans; Interferons - therapeutic use; Liver Cirrhosis - complications; Liver Cirrhosis - drug therapy; Liver Neoplasms - drug therapy; Liver Neoplasms - surgery; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Medical sciences; Pharmacology. Drug treatments; Secondary Prevention; Treatment Outcome; Tumors; Prognosis; Cytokine; Hepatic disease; Hepatocellular carcinoma; Surgical resection; Malignant tumor; Ablation; Metaanalysis; Liver cancer; Treatment; Surgery; Digestive diseases; Interferon; Cancer
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/j.1365-2036.2010.04414.x

Aliment Pharmacol Ther 2010; 32: 851–858
Summary
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.