Effects of a 24-week course of interferon-αtherapy after curative treatment of hepatitis C virus-associated hepatocellular carcinoma

摘要

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.