Low-Dose, Long-Term, Intermittent Interferon-alpha-2b Therapy after Radical Treatment by Radiofrequency Ablation Delays Clinical Recurrence in Patients with Hepatitis C Virus-Related Hepatocellular Carcinoma

Objective: To assess whether or not interferon (IFN) therapy prevents recurrence, and eventually improves the prognosis of patients with hepatocellular carcinoma (HCC) after completion of radical radiofrequency ablation (RFA) therapy. Methods: Included as the IFN group in this study were 24 patients in total, who received radical RFA therapy first, followed by medication with IFN-α2b at such a low dose of 3 MIU × 2/week for as long as possible. On the other hand, the control group comprised 33 patients in total, who received radical RFA therapy without subsequent treatment with IFN. The control group was matched to the IFN group in age, platelet counts and size of nodules. Results: Of the 24 patients treated with IFN, only one patient showed sustained virologic response. The median tumor-free period until the first recurrence after radical RFA therapy was 3.4 years in the IFN group and 1.4 years in the control group (p = 0.02). During the first 3 years after commencement of IFN administration, the cumulative recurrence rate in the IFN group was found to be lower than in the control group (p = 0.01); however, with the lapse of time over 3 years, the recurrence rate in the IFN group increased. There was no difference in the cumulative survival rates between the IFN group and the control group (p = 0.25). Conclusion: Subsequently after radical RFA therapy, long-term, low-dose, intermittent IFN therapy successfully delayed clinical recurrence of HCC.

[1]  L. Qin,et al.  Mechanism of interferon alpha on inhibition of metastasis and angiogenesis of hepatocellular carcinoma after curative resection in nude mice , 2003, Journal of Gastrointestinal Surgery.

[2]  M. Kudo Contrast harmonic ultrasound is a breakthrough technology in the diagnosis and treatment of hepatocellular carcinoma , 2001, Journal of Medical Ultrasonics.

[3]  Y. Liaw,et al.  Prospective randomized controlled study of interferon‐alpha in preventing hepatocellular carcinoma recurrence after medical ablation therapy for primary tumors , 2004, Cancer.

[4]  Masatoshi Kudo,et al.  Local ablation therapy for hepatocellular carcinoma: current status and future perspectives , 2004, Journal of Gastroenterology.

[5]  Yoshiyuki Suzuki,et al.  Significance of multicentric cancer recurrence after potentially curative ablation of hepatocellular carcinoma: a longterm cohort study of 892 patients with viral cirrhosis , 2003, Journal of Gastroenterology.

[6]  Hideo Negishi,et al.  Integration of interferon-α/β signalling to p53 responses in tumour suppression and antiviral defence , 2003, Nature.

[7]  Masatoshi Kudo,et al.  Radiofrequency ablation of hepatocellular carcinoma: therapeutic response using contrast-enhanced coded phase-inversion harmonic sonography. , 2003, AJR. American journal of roentgenology.

[8]  Zhao-You Tang,et al.  Preventive treatments for recurrence after curative resection of hepatocellular carcinoma--a literature review of randomized control trials. , 2003, World journal of gastroenterology.

[9]  A. Tamori,et al.  Relationship between response to previous interferon therapy and postoperative recurrence of hepatitis C virus-related hepatocellular carcinoma. , 2002, Hepatology research : the official journal of the Japan Society of Hepatology.

[10]  S. Kubo,et al.  Randomized clinical trial of long‐term outcome after resection of hepatitis C virus‐related hepatocellular carcinoma by postoperative interferon therapy , 2002, The British journal of surgery.

[11]  M. Kudo,et al.  Evaluation of posttreatment response of hepatocellular carcinoma with contrast-enhanced coded phase-inversion harmonic US: comparison with dynamic CT. , 2001, Radiology.

[12]  H. Kawasaki,et al.  Interferon alpha inhibits intrahepatic recurrence in hepatocellular carcinoma with chronic hepatitis C: a pilot study. , 2001, Hepatology research : the official journal of the Japan Society of Hepatology.

[13]  A. Tamori,et al.  Effects of Long-Term Postoperative Interferon- Therapy on Intrahepatic Recurrence after Resection of Hepatitis C VirusRelated Hepatocellular Carcinoma , 2001, Annals of Internal Medicine.

[14]  M. Kudo,et al.  Contrast-enhanced subtraction harmonic sonography for evaluating treatment response in patients with hepatocellular carcinoma. , 2001, AJR. American journal of roentgenology.

[15]  K. Wakasa,et al.  Influence of Previous Interferon Therapy on Recurrence after Resection of Hepatitis C Virus‐related Hepatocellular Carcinoma , 2001, Japanese journal of cancer research : Gann.

[16]  Y. Shiratori,et al.  Risk factors for recurring hepatocellular carcinoma differ according to infected hepatitis virus—An analysis of 236 consecutive patients with a single lesion , 2000, Hepatology.

[17]  K. Wakasa,et al.  Risk Factors for Recurrence after Resection of Hepatitis C Virus-related Hepatocellular Carcinoma , 2000, World Journal of Surgery.

[18]  K. Chayama,et al.  Interferon beta prevents recurrence of hepatocellular carcinoma after complete resection or ablation of the primary tumor—A prospective randomized study of hepatitis C virus–related liver cancer , 2000, Hepatology.

[19]  D. Grandér,et al.  Molecular mechanisms underlying interferon-α-induced G0/G1 arrest: CKI-mediated regulation of G1 Cdk-complexes and activation of pocket proteins , 1999, Oncogene.

[20]  M. Shindo,et al.  Varying incidence of cirrhosis and hepatocellular carcinoma in patients with chronic hepatitis C responding differently to interferon therapy , 1999, Cancer.

[21]  K. Chayama,et al.  Effect of interferon therapy on hepatocellular carcinogenesis in patients with chronic hepatitis type C: A long‐term observation study of 1,643 patients using statistical bias correction with proportional hazard analysis , 1999, Hepatology.

[22]  H. El‐Serag,et al.  Rising incidence of hepatocellular carcinoma in the United States. , 1999, The New England journal of medicine.

[23]  N. Hayashi,et al.  Risk factors for hepatocellular carcinoma and its incidence after interferon treatment in patients with chronic hepatitis C , 1998, Hepatology.

[24]  S. Seki,et al.  Randomised trial of effects of interferon-α on incidence of hepatocellular carcinoma in chronic active hepatitis C with cirrhosis , 1995, The Lancet.

[25]  D. Ingber,et al.  Inhibition of angiogenesis. , 1992, Seminars in cancer biology.

[26]  Eugene R. Schiff,et al.  Treatment of Chronic Hepatitis C with Recombinant Interferon Alfa , 1989 .

[27]  I. Fujimoto,et al.  Changing incidence of hepatocellular carcinoma in Japan. , 1987, Cancer research.

[28]  G. Trinchieri,et al.  Spontaneous cell-mediated cytotoxicity in humans. Distribution and characterization of the effector cell. , 1978, Clinical and experimental immunology.

[29]  G. Trinchieri,et al.  Spontaneous cell-mediated cytotoxicity in humans: role of interferon and immunoglobulins. , 1978, Journal of immunology.

[30]  I. Gresser,et al.  Enhancement by interferon of the specific cytotoxicity of sensitized lymphocytes. , 1972, Proceedings of the National Academy of Sciences of the United States of America.