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Ann Intern Med. 2003 Feb 18;138(4):299-306.

Interferon therapy after tumor ablation improves prognosis in patients with hepatocellular carcinoma associated with hepatitis C virus.

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1
Department of Gastroenterology, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113, Japan. shirato@cc.okayama-u.ac.jp

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 (< or =2 x 10(6) 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.

PMID:
12585827
[Indexed for MEDLINE]
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