Patients with the hepatitis C virus (HCV) have a risk of frequent recurrence and deterioration of liver function, even after curative treatment for the primary hepatocellular carcinoma (HCC). This unfavorable prognosis is associated with a sustained HCV infection. Thus, both the prevention of HCC recurrence and the preservation of liver function are high priorities when trying to improve the prognosis of patients with HCV-related HCC. Antiviral therapy for chronic hepatitis C (HCV) after treatment for primary HCC is the essential factor required for an improved prognosis.
A research article written by a study group at Japan's Hiroshima University Hospital, published on October 28 in the World Journal of Gastroenterology, suggests the importance of viral eradication. This study group performed a matched case-controlled study and compared 42 patients undergoing a 24-week course of interferon therapy and 42 patients who did not receive any interferon therapy. The purpose of the study was to determine whether a 24-week course of interferon-alpha therapy after curative treatment for HCV-associated HCC could possibly influence tumor recurrence, patient survival, and liver function.
The study group found that the second recurrence rate was significantly lower in patients that underwent interferon therapy as compared to those patients that did not have interferon therapy, although the first recurrence rate in patients with and without interferon therapy did not differ. Additionally, results also indicated that the interferon therapy patients had longer survival periods than the patients who did not have interferon therapy.
The study group also determined that when patients without interferon therapy were compared to patients without any virological response, only the virological responders within the interferon therapy group had a better prognosis with regard to the recurrence, liver function, and survival. Overall, the results indicated it is the sustained virological response that is the most important factor for decreasing the risk of HCC recurrence, including for the second recurrence and for prolonged survival. The state of the virological response improved the prognosis by suppressing the multicentric recurrence, which was related to the sustained hepatic necrosis and inflammation.
The study group also demonstrated that the state of the sustained virological response was responsible for preventing functional liver deterioration, which is related to the underlying HCV-related hepatic damage. Thus, patients with viral elimination are able to survive longer than both the patients without interferon therapy and the patients without virological response following interferon therapy, due to the decreased HCC recurrence and preservation of hepatic function.
After curative treatment of primary HCC, a 24-week course of interferon therapy should be recommended for the purpose of viral eradication.
Reference: Jeong SC, Aikata H, Katamura Y, Azakami T, Kawaoka T, Saneto H, Uka K, Mori N, Takaki S, Kodama H, Waki K, Imamura M, Shirakawa H, Kawakami Y, Takahashi S, Chayama K.Effects of a 24-week course of interferon-alpha therapy after curative treatment of hepatitis C virus-associated hepatocellular carcinoma. World J Gastroenterol 2007; 13(40): 5343-5350
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