Effects of interferon alpha treatment on recurrence and survival after complete resection or ablation of hepatocellular carcinoma: A meta-analysis of randomized controlled trials


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Abstract

Available literature on the benefit of interferon alpha (IFN-α) as adjuvant postsurgical or ablative treatment of hepatocellular carcinoma reports discordant results. By meta-analysis of the available data, we evaluated the effects of IFN-α on recurrence and survival after complete resection or ablation of hepatocellular carcinoma. All randomized controlled trials comparing IFN-α with placebo or no treatment after tumor resection or ablation were selected. Finally, 6 studies published in 2001 or later with a total of 600 patients were included in this meta-analysis. Data on postsurgical or ablative early recurrence and 1 year survival of hepatocellular carcinoma in IFN-α treated and untreated patients were extracted from each study. Proportions were combined, and the odds ratio (OR) with its 95% confidence interval (CI) was used as the effect size estimate. Analysis results show that IFN-α significantly decreased postsurgical or ablative overall early recurrence (OR = 0.62; 95% CI = 0.42–0.93;p= 0.02) and improved overall 1 year survival (OR = 3.14; 95% CI = 1.79–5.52;p< 0.0001). Subgroup analyses show that IFN-α decreased postsurgical early recurrence (OR = 0.58; 95% CI = 0.37–0.91;p= 0.02) and improved 1 year survival (OR = 3.19; 95% CI = 1.80–5.67;p< 0.0001) evidently. Subgroup analyses also show that IFN-α reduced early recurrence after resection without pre-resection ablation therapy (OR = 0.58; 95% CI = 0.37–0.91;p= 0.02) and improved 1 year survival (OR = 3.83; 95% CI = 2.01–7.27;p< 0.0001). These results suggest that IFN-α treatment could significantly decrease early recurrence and improve 1 year survival of patients with hepatocellular carcinoma after complete resection or ablation. The use of IFN-α as adjuvant postsurgical or ablative treatment seems promising but requires further study. © 2009 UICC

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