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Article: A randomized, controlled trial of postoperative adjuvant interferon therapy after resection of hepatocellular carcinoma
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TitleA randomized, controlled trial of postoperative adjuvant interferon therapy after resection of hepatocellular carcinoma
 
AuthorsLo, CM1 1
Liu, CL1
Chan, SC1
Lam, CM1
Poon, RTP1
Ng, IOL1
Fan, ST1
Wong, J1
 
Issue Date2007
 
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.com
 
CitationAnnals Of Surgery, 2007, v. 245 n. 6, p. 831-842 [How to Cite?]
DOI: http://dx.doi.org/10.1097/01.sla.0000245829.00977.45
 
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.
 
ISSN0003-4932
2012 Impact Factor: 6.329
2012 SCImago Journal Rankings: 3.006
 
DOIhttp://dx.doi.org/10.1097/01.sla.0000245829.00977.45
 
PubMed Central IDPMC1876947
 
ISI Accession Number IDWOS:000246873000001
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorLo, CM
 
dc.contributor.authorLiu, CL
 
dc.contributor.authorChan, SC
 
dc.contributor.authorLam, CM
 
dc.contributor.authorPoon, RTP
 
dc.contributor.authorNg, IOL
 
dc.contributor.authorFan, ST
 
dc.contributor.authorWong, J
 
dc.date.accessioned2010-09-06T09:45:18Z
 
dc.date.available2010-09-06T09:45:18Z
 
dc.date.issued2007
 
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.
 
dc.description.naturelink_to_OA_fulltext
 
dc.identifier.citationAnnals Of Surgery, 2007, v. 245 n. 6, p. 831-842 [How to Cite?]
DOI: http://dx.doi.org/10.1097/01.sla.0000245829.00977.45
 
dc.identifier.doihttp://dx.doi.org/10.1097/01.sla.0000245829.00977.45
 
dc.identifier.eissn1528-1140
 
dc.identifier.epage842
 
dc.identifier.hkuros127612
 
dc.identifier.isiWOS:000246873000001
 
dc.identifier.issn0003-4932
2012 Impact Factor: 6.329
2012 SCImago Journal Rankings: 3.006
 
dc.identifier.issue6
 
dc.identifier.openurl
 
dc.identifier.pmcidPMC1876947
 
dc.identifier.pmid17522506
 
dc.identifier.scopuseid_2-s2.0-34249316548
 
dc.identifier.spage831
 
dc.identifier.urihttp://hdl.handle.net/10722/88584
 
dc.identifier.volume245
 
dc.languageeng
 
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.com
 
dc.publisher.placeUnited States
 
dc.relation.ispartofAnnals of Surgery
 
dc.relation.referencesReferences in Scopus
 
dc.rightsThis is a non-final version of an article published in final form in Annals of Surgery, 2007, v. 245 n. 6, p. 831-842
 
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 carcinoma
 
dc.typeArticle
 
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Author Affiliations
  1. The University of Hong Kong