Interferon Therapy after Tumor Ablation Improves Prognosis in Patients with Hepatocellular Carcinoma Associated with Hepatitis C Virus

Interferon Therapy after Tumor Ablation Improves Prognosis in Patients with Hepatocellular Carcinoma Associated with Hepatitis C Virus

From University of Tokyo, Tokyo, Japan.

Abstract

Background: Even after the surgical or medical treatment of hepatocellular carcinoma, tumors frequently develop at new foci, leading to a poor prognosis.

Objective: To assess whether combined tumor ablation and interferon therapy can reduce the occurrence of new foci of hepatocellular carcinoma, thereby improving survival rate.

Design: Randomized, controlled study.

Setting: University hospital.

Patients: 74 patients with compensated cirrhosis, three or fewer nodules of hepatocellular carcinoma, and low hepatitis C virus RNA loads (≤ 2 × 10⁶ copies/mL).

Intervention: After all patients had complete ablation of lesions by percutaneous ethanol injection therapy, 49 patients were assigned to receive 6 million U of interferon three times weekly for 48 weeks and 25 did not receive treatment.

Measurements: Abdominal ultrasonography, computed tomography, and determination of blood biochemical measures.

Results: Of the 49 patients treated with interferon, 21 showed a sustained biochemical response and 14 showed a sustained virologic response. The rate of first recurrence of new foci of hepatocellular carcinoma was similar in patients treated with interferon and untreated patients; however, the rates of second or third recurrence seemed to be lower in the interferon group than in the untreated group. Patients treated with interferon had a survival rate of 68% at 5 years and 53% at 7 years; untreated patients had a survival rate of 48% at 5 years and 23% at 7 years.

Conclusion: After tumor ablation by ethanol injection, interferon therapy may enhance patient survival in selected patients with chronic hepatitis C.

Article and Author Information

Requests for Single Reprints: Yasushi Shiratori, MD, Department of Gastroenterology, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113, Japan; e-mail, shirato{at}cc.okayama-u.ac.jp.
Current Author Addresses: Dr. Shiratori, Department of Gastroenterology, Hepatology, and Infectious Diseases, Okayama University School of Medicine and Dentistry, 2-5-1 Shikata-cho, Okayama-city, Okayama 700, Japan
Drs. Shiina, Teratani, Imamura, Obi, Sato, Koike, Yoshida, and Omata: Department of Gastroenterology, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113, Japan.
Author Contributions: Conception and design: Y. Shiratori, S. Shiina, T. Teratani, M. Imamura, S. Obi, S. Sato, Y. Koike, H. Yoshida, M. Omata.
Analysis and interpretation of the data: Y. Shiratori, H. Yoshida.
Drafting of the article: Y. Shiratori.
Critical revision of the article for important intellectual content: Y. Shiratori, S. Shiina, T. Teratani, M. Imamura, S. Obi, S. Sato, Y. Koike, H. Yoshida, M. Omata.
Final approval of the article: Y. Shiratori, M. Omata.
Provision of study materials or patients: Y. Shiratori, S. Shiina, T. Teratani, M. Imamura, S. Obi, S. Sato, Y. Koike, M. Omata.
Statistical expertise: Y. Shiratori, H. Yoshida.
Obtaining of funding: Y. Shiratori, M. Omata.
Administrative, technical, or logistic support: Y. Shiratori, M. Omata.
Collection and assembly of data: Y. Shiratori, S. Shiina, T. Teratani, M. Imamura, S. Obi, S. Sato, Y. Koike.