Open AccessSystematic review and meta‐analysis of interferon after curative treatment of hepatocellular carcinoma in patients with viral hepatitis
Author(s) -
Breitenstein S.,
Dimitroulis D.,
Petrowsky H.,
Puhan M. A.,
Müllhaupt B.,
Clavien P.A.
Publication year - 2009
Publication title -
british journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.202
H-Index - 201
eISSN - 1365-2168
pISSN - 0007-1323
DOI - 10.1002/bjs.6731
Subject(s) - medicine , hepatocellular carcinoma , meta analysis , adjuvant , gastroenterology , confidence interval , interferon , randomized controlled trial , surgery , immunology
Background: A combined antiviral and tumoricidal effect of interferon (IFN) is assumed to occur after resection or ablation of hepatocellular carcinoma (HCC). Methods: An electronic search of the Medline, Embase and Central databases from January 1998 to October 2007 was conducted to identify randomized controlled trials evaluating adjuvant effects of IFN after curative treatment of HCC. A meta‐analysis was performed to estimate the effects of IFN on 2‐year outcome. Results: Seven trials enrolling a total of 620 patients were included in the meta‐analysis. Adjuvant treatment with IFN significantly reduced the 2‐year mortality rate after curative treatment of HCC, with a pooled risk ratio of 0·65 (95 per cent confidence interval 0·52 to 0·80); P < 0·001) in absence of any significant heterogeneity ( I 2 = 0 per cent, P = 0·823 for χ 2 ). The effect on reduction of tumour recurrence was less pronounced but still significant (pooled risk ratio 0·86 (95 per cent c.i. 0·76 to 0·97); P = 0·013). IFN had to be discontinued in 8–20 per cent of patients. Conclusion: IFN has a significant beneficial effect after curative treatment of HCC in terms of both survival and tumour recurrence. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.