A meta-analysis and systematic review: adjuvant interferon therapy for patients with viral hepatitis-related hepatocellu
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WORLD JOURNAL OF SURGICAL ONCOLOGY
REVIEW
Open Access
A meta-analysis and systematic review: adjuvant interferon therapy for patients with viral hepatitisrelated hepatocellular carcinoma Shaojie Jiang1*, Yingxia Liu2, Linhai Wang1, Chenyang Duan3 and Mengying Liu4
Abstract Objective: To evaluate the efficacy and safety of adjuvant IFN therapy for viral hepatitis-related hepatocellular carcinoma (HCC) after treatment with surgical resection or transarterial chemoembolization (TACE). Methods: Controlled trials of adjuvant treatment with IFN for patients with HCC published between 2000 and 2012 were searched electronically in MEDLINE, PubMed, Cochrane Library, and EMBASE databases. According to the heterogeneity of the studies, two different models - the fixed-effect model and the random-effect model - were applied to analyze the results. Results: Ten trials were screened according to inclusion and exclusion standards. Eight randomized, controlled trials and two non-randomized, controlled trials were included. These ten trials with a total of 1,029 subjects were eventually involved in the meta-analysis; 528 HCC patients were treated with adjuvant treatment with IFN and 501 patients with placebo. Compared to the control group, the recurrence rates of HCC in IFN group were significantly lower (odds ratio (OR) = 0.66; 95% confidence interval (CI) = 0.50 to 0.86; P = 0.02), especially after TACE treatment according to subgroup analysis (OR = 0.73; 95% CI = 0.52 to 1.01; P = 0.06 for surgical resection; and OR = 0.54; 95% CI = 0.33 to 0.86, P = 0.01 for TACE). The death rates in the IFN group also significantly decreased according to not only total events analysis (OR = 0.42; 95% CI = 0.32 to 0.56; P < 0.00001) but also subgroup analysis (OR = 0.51; 95% CI = 0.36 to 0.72; P = 0.0002 for surgical resection; and OR = 0.33; 95% CI = 0.21 to 0.50; P < 0.00001 for TACE). Conclusions: Adjuvant IFN therapy may significantly reduce the recurrence rates of patients with viral hepatitisrelated HCC and improve the survival of patients after surgical resection or TACE. The ideal dose mostly selected is 3 MIU/ml, three times per week, which can make patients tolerate the adverse reactions of IFN better and maintain effective concentrations for a long time. Keywords: Interferon, Adjuvant treatment, Viral hepatitis, Hepatocellular carcinoma, Meta-analysis
Review Introduction
Primary liver cancer, which consists predominantly of hepatocellular carcinoma (HCC), is the fifth most common cancer worldwide and the third most common cause of cancer mortality [1]. Due to the high degree of malignancy and the difficulty of diagnosis in the early stage, the lesions of most patients have already metastasised when they first see a doctor [2]. However, only approximately 10 to 30% * Correspondence: [email protected] 1 Department of Hepatobiliary Surgery, Shenyang Military Region General Hospital, Shenhe District in Shenyang culture road no. 83, Shenyang 110015, China Full list of author information is available at the end of the articl
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