Effects of interferon alpha treatment on recurrence and survival after complete resection or ablation of hepatocellular carcinoma: A meta‐analysis of randomized controlled trials

Available literature on the benefit of interferon alpha (IFN‐α) as adjuvant postsurgical or ablative treatment of hepatocellular carcinoma reports discordant results. By meta‐analysis of the available data, we evaluated the effects of IFN‐α on recurrence and survival after complete resection or ablation of hepatocellular carcinoma. All randomized controlled trials comparing IFN‐α with placebo or no treatment after tumor resection or ablation were selected. Finally, 6 studies published in 2001 or later with a total of 600 patients were included in this meta‐analysis. Data on postsurgical or ablative early recurrence and 1 year survival of hepatocellular carcinoma in IFN‐α treated and untreated patients were extracted from each study. Proportions were combined, and the odds ratio (OR) with its 95% confidence interval (CI) was used as the effect size estimate. Analysis results show that IFN‐α significantly decreased postsurgical or ablative overall early recurrence (OR = 0.62; 95% CI = 0.42–0.93; p = 0.02) and improved overall 1 year survival (OR = 3.14; 95% CI = 1.79–5.52; p < 0.0001). Subgroup analyses show that IFN‐α decreased postsurgical early recurrence (OR = 0.58; 95% CI = 0.37–0.91; p = 0.02) and improved 1 year survival (OR = 3.19; 95% CI = 1.80–5.67; p < 0.0001) evidently. Subgroup analyses also show that IFN‐α reduced early recurrence after resection without pre‐resection ablation therapy (OR = 0.58; 95% CI = 0.37–0.91; p = 0.02) and improved 1 year survival (OR = 3.83; 95% CI = 2.01–7.27; p < 0.0001). These results suggest that IFN‐α treatment could significantly decrease early recurrence and improve 1 year survival of patients with hepatocellular carcinoma after complete resection or ablation. The use of IFN‐α as adjuvant postsurgical or ablative treatment seems promising but requires further study. © 2009 UICC