Abstract
BackgroundThe effect of interferon(IFN) in the management of hepatocellular carcinoma (HCC) remains controversial, and no clear recommendations have been proposed.ObjectivesTo evaluate the effect and safety of IFN for HCC.MethodsPubMed, OvidSP, and Cochrane Library were searched from their establishment date until August 30, 2012. Studies that met the inclusion criteria were systematically evaluated and then subjected to meta-analysis.ResultsThirteen randomized control trials (RCTs) involving 1344 patients were eligible for this study. When IFN was used as an adjuvant therapy for HCC patients after curative therapy, the meta-analysis showed that IFN reduced the 1-, 2-, 3-, 4-, and 5-year recurrence rates. Subgroup analysis showed that IFN reduced the 2-, 3-, 4-, and 5-year recurrence rates of hepatitis C viral (HCV)-related HCC. The effect of IFN for on hepatitis B virus(HBV)-related HCC patients could not be determined because of isufficient data. After surgical resection, adjuvant IFN therapy reduced the 4- and 5- recurrence rates. All studies reported that IFN could not improve the overall survival of HCV-realated HCC patients after curative therapies. Only one study showed that IFN was associated with better overall survival in HCC patients after curative therapy and subgroup of HCC patients after surgical resection. Thus, meta-analysis was not performed. Different treatment options were used as control to study the effect of IFN for intermediate and advanced HCC patients, thus meta-analysis was not appropriate. All included studies, except for one, reported that IFN treatment was well tolerated.ConclusionsAfter curative therapies, adjuvant IFN reduced the recurrence of HCC. IFN did not improve the survival of HCV-related HCC patients after curative therapy. Whether IFN is effective for intermediate and advanced HCC patients could not be determined because of insufficient data. The toxicity of IFN was acceptable.
Highlights
Hepatocellular carcinoma (HCC), the most common type of hepatobiliary cancer, is highly lethal
After curative therapies, adjuvant IFN reduced the recurrence of hepatocellular carcinoma (HCC)
IFN did not improve the survival of HCVrelated HCC patients after curative therapy
Summary
Hepatocellular carcinoma (HCC), the most common type of hepatobiliary cancer, is highly lethal. The optimal therapy for HCC remains surgical resection, with a 5-year survival rate of 40% to 70% [5,6] and a 5-year recurrence rate of 75% to100% [7,8]. An appropriate multimodality treatment remains unavailable to date. Viral load is a useful prognostic marker for HBV-related HCC, and a low level of viral load represents a favorable outcome. In their gene-expression signature study, Hoshida et al [14] suggested that the extent of liver damage and the presence of protein-inflammatory milieu may lead to an increased risk for disease recurrence in postoperative HCC patients. The effect of interferon(IFN) in the management of hepatocellular carcinoma (HCC) remains controversial, and no clear recommendations have been proposed
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