A meta-analysis and systematic review: adjuvant interferon therapy for patients with viral hepatitis-related hepatocellular carcinoma

World Journal of Surgical Oncology

Mengying Liu³  Chenyang Duan⁴  Linhai Wang¹  Yingxia Liu²  Shaojie Jiang¹ 

[1] Department of Hepatobiliary Surgery, Shenyang Military Region General Hospital, Shenhe District in Shenyang culture road no. 83, Shenyang 110015, China;Department of Stomatology, Shenyang Military Region General Hospital, Shenyang, Liaoning 110015, China;Company Two of Cadet Brigade, Third Military Medical University, Chongqing 400038, China;Company Five of Cadet Brigade, Third Military Medical University, Chongqing 400038, China

关键词: Meta-analysis;    Hepatocellular carcinoma;    Viral hepatitis;    Adjuvant treatment;    Interferon;   

Others  :  821731
DOI  :  10.1186/1477-7819-11-240

 received in 2013-06-15, accepted in 2013-09-05,  发布年份 2013

【 摘 要 】

Objective

To evaluate the efficacy and safety of adjuvant IFN therapy for viral hepatitis-related hepatocellular carcinoma (HCC) after treatment with surgical resection or transarterial chemoembolization (TACE).

Methods

Controlled trials of adjuvant treatment with IFN for patients with HCC published between 2000 and 2012 were searched electronically in MEDLINE, PubMed, Cochrane Library, and EMBASE databases. According to the heterogeneity of the studies, two different models - the fixed-effect model and the random-effect model - were applied to analyze the results.

Results

Ten trials were screened according to inclusion and exclusion standards. Eight randomized, controlled trials and two non-randomized, controlled trials were included. These ten trials with a total of 1,029 subjects were eventually involved in the meta-analysis; 528 HCC patients were treated with adjuvant treatment with IFN and 501 patients with placebo. Compared to the control group, the recurrence rates of HCC in IFN group were significantly lower (odds ratio (OR) = 0.66; 95% confidence interval (CI) = 0.50 to 0.86; P = 0.02), especially after TACE treatment according to subgroup analysis (OR = 0.73; 95% CI = 0.52 to 1.01; P = 0.06 for surgical resection; and OR = 0.54; 95% CI = 0.33 to 0.86, P = 0.01 for TACE). The death rates in the IFN group also significantly decreased according to not only total events analysis (OR = 0.42; 95% CI = 0.32 to 0.56; P < 0.00001) but also subgroup analysis (OR = 0.51; 95% CI = 0.36 to 0.72; P = 0.0002 for surgical resection; and OR = 0.33; 95% CI = 0.21 to 0.50; P < 0.00001 for TACE).

Conclusions

Adjuvant IFN therapy may significantly reduce the recurrence rates of patients with viral hepatitis-related HCC and improve the survival of patients after surgical resection or TACE. The ideal dose mostly selected is 3 MIU/ml, three times per week, which can make patients tolerate the adverse reactions of IFN better and maintain effective concentrations for a long time.

【 授权许可】

   
2013 Jiang et al.; licensee BioMed Central Ltd.

【 图 表 】

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