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Article: A randomized, controlled trial of postoperative adjuvant interferon therapy after resection of hepatocellular carcinoma

TitleA randomized, controlled trial of postoperative adjuvant interferon therapy after resection of hepatocellular carcinoma
Authors
Issue Date2007
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.com
Citation
Annals Of Surgery, 2007, v. 245 n. 6, p. 831-842 How to Cite?
AbstractOBJECTIVE: We conducted a randomized controlled trial of adjuvant interferon therapy in patients with predominantly hepatitis B-related hepatocellular carcinoma (HCC) to investigate whether the prognosis after hepatic resection could be improved. SUMMARY BACKGROUND DATA: Recurrence is common after hepatic resection for HCC. Interferon possesses antiviral, immunomodulatory, antiproliferative, and antiangiogenic effects and may be an effective form of adjuvant therapy. PATIENTS AND METHODS: Since February 1999, patients with no residual disease after hepatic resection for HCC were randomly assigned with stratification by pTNM stage to receive no treatment (control group), interferon alpha-2b 10 MIU/m (IFN-I group) or 30 MIU/m (IFN-II group) thrice weekly for 16 weeks. Enrollment to the IFN-II group was terminated from January 2000 because adverse effects resulted in treatment discontinuation in the first 6 patients. By June 2002, 40 patients each had been enrolled into the control group and IFN-I group. The baseline clinical, laboratory, and tumor characteristics of both groups were comparable. RESULTS: The 1- and 5-year survival rates were 85% and 61%, respectively, for the control group and 97% and 79%, respectively, for the IFN-I group (P = 0.137). After adjusting for the confounding prognostic factors in a Cox model, the relative risk of death for interferon treatment was 0.42 (95% CI, 0.17-1.05; P = 0.063). Exploratory subset analysis showed that adjuvant interferon had no survival benefit for pTNM stage I/II tumor (5-year survival 90% in both groups; P = 0.917) but prevented early recurrence and improved the 5-year survival of patients with stage III/IVA tumor from 24% to 68% (P = 0.038). CONCLUSION: In a group of patients with predominantly hepatitis B-related HCC, adjuvant interferon therapy showed a trend for survival benefit, primarily in those with pTNM stage III/IVA tumors. Further larger randomized trials stratified for stage are needed. © 2007 Lippincott Williams & Wilkins, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/88584
ISSN
2014 Impact Factor: 8.327
PubMed Central ID
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLo, CMen_HK
dc.contributor.authorLiu, CLen_HK
dc.contributor.authorChan, SCen_HK
dc.contributor.authorLam, CMen_HK
dc.contributor.authorPoon, RTPen_HK
dc.contributor.authorNg, IOLen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-09-06T09:45:18Z-
dc.date.available2010-09-06T09:45:18Z-
dc.date.issued2007en_HK
dc.identifier.citationAnnals Of Surgery, 2007, v. 245 n. 6, p. 831-842en_HK
dc.identifier.issn0003-4932en_HK
dc.identifier.urihttp://hdl.handle.net/10722/88584-
dc.description.abstractOBJECTIVE: We conducted a randomized controlled trial of adjuvant interferon therapy in patients with predominantly hepatitis B-related hepatocellular carcinoma (HCC) to investigate whether the prognosis after hepatic resection could be improved. SUMMARY BACKGROUND DATA: Recurrence is common after hepatic resection for HCC. Interferon possesses antiviral, immunomodulatory, antiproliferative, and antiangiogenic effects and may be an effective form of adjuvant therapy. PATIENTS AND METHODS: Since February 1999, patients with no residual disease after hepatic resection for HCC were randomly assigned with stratification by pTNM stage to receive no treatment (control group), interferon alpha-2b 10 MIU/m (IFN-I group) or 30 MIU/m (IFN-II group) thrice weekly for 16 weeks. Enrollment to the IFN-II group was terminated from January 2000 because adverse effects resulted in treatment discontinuation in the first 6 patients. By June 2002, 40 patients each had been enrolled into the control group and IFN-I group. The baseline clinical, laboratory, and tumor characteristics of both groups were comparable. RESULTS: The 1- and 5-year survival rates were 85% and 61%, respectively, for the control group and 97% and 79%, respectively, for the IFN-I group (P = 0.137). After adjusting for the confounding prognostic factors in a Cox model, the relative risk of death for interferon treatment was 0.42 (95% CI, 0.17-1.05; P = 0.063). Exploratory subset analysis showed that adjuvant interferon had no survival benefit for pTNM stage I/II tumor (5-year survival 90% in both groups; P = 0.917) but prevented early recurrence and improved the 5-year survival of patients with stage III/IVA tumor from 24% to 68% (P = 0.038). CONCLUSION: In a group of patients with predominantly hepatitis B-related HCC, adjuvant interferon therapy showed a trend for survival benefit, primarily in those with pTNM stage III/IVA tumors. Further larger randomized trials stratified for stage are needed. © 2007 Lippincott Williams & Wilkins, Inc.en_HK
dc.languageengen_HK
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.comen_HK
dc.relation.ispartofAnnals of Surgeryen_HK
dc.rightsThis is a non-final version of an article published in final form in Annals of Surgery, 2007, v. 245 n. 6, p. 831-842en_HK
dc.subject.meshAntineoplastic Agents - adverse effects - therapeutic use-
dc.subject.meshCarcinoma, Hepatocellular - drug therapy - pathology - surgery - virology-
dc.subject.meshInterferon-alpha - adverse effects - therapeutic use-
dc.subject.meshLiver Neoplasms - drug therapy - pathology - surgery - virology-
dc.subject.meshProportional Hazards Models-
dc.titleA randomized, controlled trial of postoperative adjuvant interferon therapy after resection of hepatocellular carcinomaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0003-4932&volume=245&issue=6&spage=831&epage=842&date=2007&atitle=A+randomized,+controlled+trial+of+postoperative+adjuvant+interferon+therapy+after+resection+of+hepatocellular+carcinomaen_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailChan, SC: chanlsc@hkucc.hku.hken_HK
dc.identifier.emailPoon, RTP: poontp@hku.hken_HK
dc.identifier.emailNg, IOL: iolng@hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityChan, SC=rp01568en_HK
dc.identifier.authorityPoon, RTP=rp00446en_HK
dc.identifier.authorityNg, IOL=rp00335en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_OA_fulltexten_US
dc.identifier.doi10.1097/01.sla.0000245829.00977.45en_HK
dc.identifier.pmid17522506en_HK
dc.identifier.pmcidPMC1876947-
dc.identifier.scopuseid_2-s2.0-34249316548en_HK
dc.identifier.hkuros127612en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-34249316548&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume245en_HK
dc.identifier.issue6en_HK
dc.identifier.spage831en_HK
dc.identifier.epage842en_HK
dc.identifier.eissn1528-1140-
dc.identifier.isiWOS:000246873000001-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridLiu, CL=7409789712en_HK
dc.identifier.scopusauthoridChan, SC=7404255575en_HK
dc.identifier.scopusauthoridLam, CM=36799183200en_HK
dc.identifier.scopusauthoridPoon, RTP=7103097223en_HK
dc.identifier.scopusauthoridNg, IOL=7102753722en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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