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. 2010 Sep 24;5(1):559-66.
doi: 10.1007/s12072-010-9214-2.

Long-term interferon therapy after radiofrequency ablation is effective in treating patients with HCV-associated hepatocellular carcinoma

Soji Shimomura, Naoto Ikeda, Masaki Saito, Akio Ishii, Tomoyuki Takashima, Yoshiyuki Sakai, Shohei Yoshikawa, Nobuhiro Aizawa, Hironori Tanaka, Yoshinori Iwata, Hirayuki Enomoto, Hiroyasu Imanishi, Teruhisa Yamamoto, Hisato Jomura, Hideji Nakamura, Hiroko Iijima, Shuhei Nishiguchi

Long-term interferon therapy after radiofrequency ablation is effective in treating patients with HCV-associated hepatocellular carcinoma

Soji Shimomura et al. Hepatol Int. .

Abstract

Purpose: This study investigates the usefulness of long-term interferon (IFN) therapy following radiofrequency ablation (RFA) for HCV-associated hepatocellular carcinoma (HCC).

Methods: This is a retrospective observational study. Patients underwent pegylated IFN-α/ribavirin combination therapy for 48 weeks and then were maintained on IFN-α administration on average for 68 weeks (mean total duration 116 weeks). Patients who underwent IFN monotherapy were maintained on IFN administration on average for 78 weeks.

Results: There were biases in the background factors between the IFN and non-IFN groups. Therefore, a covariate adjustment was performed using the propensity score. An analysis of 20-matched patients from each group showed the 5-year cumulative survival rate was higher in the IFN group than in the non-IFN group (100 and 76%, respectively), and the 3-year cumulative recurrence rate was significantly lower in the IFN group than in the non-IFN group (38.0 and 64.2%, respectively). In 14 patients (i.e., IFN responders), the serum alanine aminotransferase (ALT) level remained normalized at 30 IU/mL or lower, regardless of disappearance of serum HCV RNA. In these patients, the cumulative recurrence rate was low, the hazard ratio was 0.158 (95% confidence interval = 0.045-0.561, P = 0.004), and the serum albumin level was retained.

Conclusion: These results show the importance of maintaining the liver function and suggest that long-term IFN administration after RFA inhibits recurrence and contributes to an improved outcome in patients (in particular, IFN responders) who initially develop HCC.

Keywords: Hepatitis C virus; Hepatocellular carcinoma; Interferon; Prevention; Radiofrequency ablation.

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Figures

Fig. 1
Fig. 1
a Cumulative survival rates after curative RFA treatment of matched patients with HCC. The cumulative rates were higher in the IFN group than in the non-IFN group (P = 0.075). b Cumulative recurrence rates after RFA treatment of matched patients with HCC. The recurrence rate of the IFN group was significantly lower than that of the non-IFN group (P = 0.019)
Fig. 2
Fig. 2
Cumulative recurrence rates according to efficacy of IFN therapy after curative RFA treatment of matched patients with HCC. The rate of cumulative recurrence of HCC in the IFN responder was significantly lower than the “Others” (P = 0.001)
Fig. 3
Fig. 3
Cumulative recurence rates after RFA treatment of matched patients with HCC. a Rates of local tumor progression was lower than that of the “Others”, but the difference was not statistically significant (P = 0.45). b Rates of ectopic recurrence of the IFN responder was significantly lower than that of the “Others” (P = 0.002)
Fig. 4
Fig. 4
Effect of IFN therapy after curative RFA treatment of matched patients with HCC on the levels of serum albumn. The bars indicate mean ± 1 SD. Serum albumin in the IFN responders was significantly better preserved than the “Others” (P = 0.001)
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