Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine Department of Hepato-Biliary-Pancreatic Surgery, Osaka City General Hospital Department of Surgery, Osaka City Juso Hospital, Osaka, Japan.
Hepatol Res. 2012 Jun;42(6):564-73. doi: 10.1111/j.1872-034X.2011.00959.x. Epub 2012 Jan 18.
Several investigators have shown that interferon (IFN) therapy can suppress the recurrence of hepatocellular carcinoma (HCC) after curative treatment. We investigated the effect of IFN therapy on the first and second HCC recurrence following hepatic resection of hepatitis C virus (HCV)-related HCC.
Subjects included 166 patients who had undergone curative resection for a single HCV-related HCC. We analyzed the outcome after initial hepatic resection and risk factors of a second HCC recurrence following treatment for the first HCC recurrence.
Using multivariate analysis, a non-sustained virological response (non-SVR) was significantly associated with a high incidence of first HCC recurrence. The rate of second HCC recurrence tended to be higher in the non-SVR group than in the SVR group. In the patients with recurrence of multiple tumors or who received non-curative treatment for recurrent HCC, the second HCC recurrence rates were significantly higher. Multivariate analysis demonstrated that non-curative treatment for first HCC recurrence was an independent risk factor for a second HCC recurrence. Among the patients who received curative treatment for their first HCC recurrence, the rates of second recurrence were significantly higher in the non-SVR group than in the SVR group. Multivariate analysis also revealed that SVR was independently associated with prevention of a second HCC recurrence.
These results suggest that on first HCC recurrence, a curative treatment should be considered in order to prevent a second recurrence if possible. In addition, IFN therapy contributes to improved prognosis after curative treatment, even in patients with recurrent HCC.
一些研究人员已经表明，干扰素（IFN）治疗可以抑制根治性治疗后肝细胞癌（HCC）的复发。我们研究了 IFN 治疗对丙型肝炎病毒（HCV）相关 HCC 根治性切除术后首次和第二次 HCC 复发的影响。
本研究纳入了 166 例接受根治性切除治疗的单个 HCV 相关 HCC 患者。我们分析了初始肝切除术后的结果，并分析了治疗首次 HCC 复发后第二次 HCC 复发的危险因素。
多变量分析显示，非持续病毒学应答（non-SVR）与首次 HCC 复发的高发生率显著相关。non-SVR 组的第二次 HCC 复发率倾向于高于 SVR 组。在复发肿瘤多的患者或因复发 HCC 而接受非根治性治疗的患者中，第二次 HCC 复发率明显较高。多变量分析表明，首次 HCC 复发的非根治性治疗是第二次 HCC 复发的独立危险因素。在首次 HCC 复发接受根治性治疗的患者中，non-SVR 组的第二次复发率明显高于 SVR 组。多变量分析还显示，SVR 与预防第二次 HCC 复发独立相关。
这些结果表明，在首次 HCC 复发时，如果可能的话，应考虑进行根治性治疗，以预防第二次复发。此外，IFN 治疗有助于改善根治性治疗后的预后，即使在复发 HCC 患者中也是如此。
