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Copyright ©2007 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 28, 2007; 13(40): 5343-5350
Published online Oct 28, 2007. doi: 10.3748/wjg.v13.i40.5343
Effects of a 24-week course of interferon-α therapy after curative treatment of hepatitis C virus-associated hepatocellular carcinoma
Soo Cheol Jeong, Hiroshi Aikata, Yoshio Katamura, Takahiro Azakami, Tomokazu Kawaoka, Hiromi Saneto, Kiminori Uka, Nami Mori, Shintaro Takaki, Hideaki Kodama, Koji Waki, Michio Imamura, Hiroo Shirakawa, Yoshiiku Kawakami, Shoichi Takahashi, Kazuaki Chayama
Soo Cheol Jeong, Hiroshi Aikata, Yoshio Katamura, Takahiro Azakami, Tomokazu Kawaoka, Hiromi Saneto, Kiminori Uka, Nami Mori, Shintaro Takaki, Hideaki Kodama, Koji Waki, Michio Imamura, Hiroo Shirakawa, Yoshiiku Kawakami, Shoichi Takahashi, Kazuaki Chayama, Department of Medicine and Molecular Science, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Hiroshi Aikata, MD, Department of Medicine and Molecular Science, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan. aikata@hiroshima-u.ac.jp
Telephone: +81-82-2575192 Fax: +81-82-2575194
Received: June 6, 2007
Revised: August 8, 2007
Accepted: September 18, 2007
Published online: October 28, 2007
Abstract

AIM: To assess whether a 24-wk course of interferon (IFN) could prevent hepatocellular carcinoma (HCC) recurrence and worsening of liver function in patients with hepatitis C virus (HCV)-infected patients after receiving curative treatment for primary HCC.

METHODS: Outcomes in 42 patients with HCV infection treated with IFN-α, after curative treatment for primary HCC (IFN group), were compared with 42 matched curatively treated historical controls not given IFN (non-IFN group).

RESULTS: Although the rate of initial recurrence did not differ significantly between IFN group and non-IFN group (0%, 44%, 61%, and 67% vs 4.8%, 53%, 81%, and 87% at 1, 3, 5, and 7 years, P = 0.153, respectively), IFN group showed a lower rate than the non-IFN group for second recurrence (0%, 10.4%, 28%, and 35% vs 0%, 30%, 59%, and 66% at 1, 3, 5 and 7 years, P = 0.022, respectively). Among the IFN group, patients with sustained virologic response (SVR) were less likely to have a second HCC recurrence than IFN patients without an SVR, or non-IFN patients. Multivariate analysis identified the lack of SVR as the only independent risk factor for a second recurrence, while SVR and Child-Pugh class A independently favored overall survival.

CONCLUSION: Most intrahepatic recurrences of HCV-related HCC occurred during persistent viral infection. Eradication of HCV is essential for the prevention of HCC recurrence and improvement of survival.

Keywords: Hepatitis C virus; Hepatocellular carcinoma; Recurrence; Survival; Sustained virological response