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Interferon‐α and 5‐fluorouracil combination therapy after palliative hepatic resection in patients with advanced hepatocellular carcinoma, portal venous tumor thrombus in the major trunk, and multiple nodules
Author(s) -
Nagano Hiroaki,
Miyamoto Atsushi,
Wada Hiroshi,
Ota Hideo,
Marubashi Shigeru,
Takeda Yutaka,
Dono Keizo,
Umeshita Koji,
Sakon Masato,
Monden Morito
Publication year - 2007
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.23033
Subject(s) - medicine , hepatocellular carcinoma , gastroenterology , cirrhosis , combination therapy , fluorouracil , radiology , chemotherapy
BACKGROUND. The authors reported previously the beneficial effects of interferon (IFN)‐α/5‐fluorouracil (5‐FU) combination therapy for patients with advanced hepatocellular carcinoma (HCC) who have tumor thrombi in the major portal branches. In this report, the authors describe the results from IFN/5‐FU chemotherapy for patients who underwent palliative hepatic resection for advanced HCC with tumor thrombus in the main trunk of the portal vein and multiple nodules in the whole liver. In addition, they evaluated the correlation between the response to such therapy and expression of IFN‐α type 2 receptor (IFNAR2). METHODS. From October 1999 to December 2004, 30 patients with advanced HCC, tumor thrombi in the main trunk of the portal vein, and multiple nodules in the whole liver (Vp4 and grade 3 intrahepatic metastases) were recruited for this study. They underwent palliative hepatic resection followed by at least 2 courses of IFN/5‐FU. IFNAR2 expression levels were determined by immunohistochemistry. RESULTS. No major treatment‐related complications were noted. An objective response was noted in 10 patients (33.3%) and included a complete response in 6 patients (20%), a partial response in 4 patients (13.3%), no response in 1 patient (3.3%), and progressive disease in 19 patients (63.4%). IFNAR2 expression was detected in 20 of 30 patients (66.7%). There was a significant difference in overall survival between patients with positive and negative IFNAR2 expression cases ( P < .0025), and a significant correlation was observed between IFNAR2 expression and response to IFN/5‐FU combination therapy ( P = .0199). CONCLUSIONS. Adjunct IFN/5‐FU therapy is a promising modality for patients with advanced HCC, tumor thrombi in the major trunk, and multiple nodules after palliative hepatic resection. The results from this study indicated that the response to such therapy seemed to be correlated with IFNAR2 expression. Cancer 2007. © 2007 American Cancer Society.