Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama 700-8558, Japan.
Int J Clin Oncol. 2011 Jun;16(3):210-20. doi: 10.1007/s10147-010-0150-x. Epub 2010 Dec 9.
We wished to determine whether pegylated interferon (PEG-IFN) therapy after curative treatment of hepatocellular carcinoma (HCC) prevents a recurrence of HCC.
Thirty-seven HCC patients with hepatitis C virus (HCV) infection who were treated with PEG-IFN after curative treatment (PEG-IFN group) and 145 controls without IFN therapy (non-IFN group) were enrolled. The overall survival and recurrence-free survival rates were compared between the groups, and the predisposing factors for recurrence and survival were analyzed. The rates were also examined by propensity score (PS) matched analysis that could minimize selection biases.
The median follow-up period was 3.7 years. The 5-year survival rate in the PEG-IFN group (91%) was significantly higher than that in the non-IFN group (56%; P < 0.01). The rate of the second recurrence but not that of the first recurrence of HCC in the sustained virological responder (SVR) group was lower than that in the non-IFN group (P = 0.03). Improvement of survival by PEG-IFN and low rate of second recurrence in the SVR group were also observed in PS matched analysis. Multivariate analysis revealed that PEG-IFN therapy and high serum albumin were good prognostic factors for survival. Although low serum albumin and large and multiple tumors were risk factors for the first recurrence, non-SVR and low serum albumin were risk factors for the second recurrence.
PEG-IFN-therapy after curative treatment of HCC improved the rate of survival, and SVR was found to be closely correlated with the prevention of recurrence.
我们希望确定聚乙二醇干扰素（PEG-IFN）治疗是否可以预防肝癌（HCC）治愈后复发。
37 例丙型肝炎病毒（HCV）感染的 HCC 患者在治愈性治疗后接受 PEG-IFN 治疗（PEG-IFN 组），145 例未接受 IFN 治疗的对照组（非 IFN 组）。比较两组的总生存率和无复发生存率，并分析复发和生存的相关因素。还通过倾向评分（PS）匹配分析来检查这些指标，以尽量减少选择偏倚。
中位随访时间为 3.7 年。PEG-IFN 组（91%）的 5 年生存率明显高于非 IFN 组（56%；P<0.01）。在持续病毒学应答（SVR）组中，第二次 HCC 复发的发生率低于非 IFN 组（P=0.03），但首次复发的发生率没有差异。在 PS 匹配分析中也观察到 PEG-IFN 改善生存和 SVR 组中第二次复发率较低的情况。多变量分析显示，PEG-IFN 治疗和高血清白蛋白是生存的良好预后因素。尽管低血清白蛋白和大肿瘤和多发病灶是首次复发的危险因素，但非 SVR 和低血清白蛋白是第二次复发的危险因素。
HCC 治愈后接受 PEG-IFN 治疗可提高生存率，且 SVR 与预防复发密切相关。
