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 ...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.展开更多
AIM: To assess the efficacy of low-dose intermittent interferon (IFN) therapy in patients with hepatitis C virus (HCV)-related compensated cirrhosis who had received curative treatment for primary hepatocellular carci...AIM: To assess the efficacy of low-dose intermittent interferon (IFN) therapy in patients with hepatitis C virus (HCV)-related compensated cirrhosis who had received curative treatment for primary hepatocellular carcinoma (HCC). METHODS: We performed a prospective case controlled study. Sixteen patients received 3 MIU of natural IFN- alpha intramuscularly 3 times weekly for at least 48 wk (IFN group). They were compared with 16 matched historical controls (non-IFN group). RESULTS: The cumulative rate of first recurrence of HCC was not significantly different between the IFN group and the non-IFN group (0% vs 6.7% and 68.6% vs 80% at 1- and 3-year, P = 0.157, respectively). The cumulative rate of second recurrence was not also significantly different between the IFN group and the non-IFN group (0% vs 6.7% and 35.9% vs 67% at 1- and 3-year, P = 0.056, respectively). Although the difference in the Child-Pugh classification score between the groups at initial treatment of HCC was not signifi cant, the score was signifi cantly worse at the time of data analysis in the non-IFN group than IFN group (7.19 ± 1.42 vs 5.81 ± 0.75, P = 0.0008). The cumulative rate of deviation from objects of any treatment for recurrentHCC was also higher in the non-IFN group than IFN group (6.7% and 27% vs 0 and 0% at 1- and 3-year, P = 0.048, respectively). CONCLUSION: Low-dose intermittent IFN-alpha therapy for patients with HCV-related compensated cirrhosis after curative HCC treatment was effective by making patients tolerant to medical or surgical treatment for recurrent HCC in the later period of observation.展开更多
文摘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.
文摘AIM: To assess the efficacy of low-dose intermittent interferon (IFN) therapy in patients with hepatitis C virus (HCV)-related compensated cirrhosis who had received curative treatment for primary hepatocellular carcinoma (HCC). METHODS: We performed a prospective case controlled study. Sixteen patients received 3 MIU of natural IFN- alpha intramuscularly 3 times weekly for at least 48 wk (IFN group). They were compared with 16 matched historical controls (non-IFN group). RESULTS: The cumulative rate of first recurrence of HCC was not significantly different between the IFN group and the non-IFN group (0% vs 6.7% and 68.6% vs 80% at 1- and 3-year, P = 0.157, respectively). The cumulative rate of second recurrence was not also significantly different between the IFN group and the non-IFN group (0% vs 6.7% and 35.9% vs 67% at 1- and 3-year, P = 0.056, respectively). Although the difference in the Child-Pugh classification score between the groups at initial treatment of HCC was not signifi cant, the score was signifi cantly worse at the time of data analysis in the non-IFN group than IFN group (7.19 ± 1.42 vs 5.81 ± 0.75, P = 0.0008). The cumulative rate of deviation from objects of any treatment for recurrentHCC was also higher in the non-IFN group than IFN group (6.7% and 27% vs 0 and 0% at 1- and 3-year, P = 0.048, respectively). CONCLUSION: Low-dose intermittent IFN-alpha therapy for patients with HCV-related compensated cirrhosis after curative HCC treatment was effective by making patients tolerant to medical or surgical treatment for recurrent HCC in the later period of observation.
