Document Detail


Postoperative peg-interferon plus ribavirin is associated with reduced recurrence of hepatitis C virus-related hepatocellular carcinoma.
MedLine Citation:
PMID:  23389758     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hepatocellular carcinoma (HCC) frequently recurs after surgical resection. This population-based research aimed to investigate the association between postoperative antiviral treatment and risk of recurrent HCC in patients with hepatitis C virus (HCV) infection. By analyzing the Taiwan National Health Insurance Research Database, we initially screened a total of 100,938 patients diagnosed with HCC for the first time between October 2003 and December 2010. Among 2,237 antiviral-naïve HCV-infected patients with curatively resected HCC, there were 213 patients receiving antiviral treatment with pegylated interferon plus ribavirin for 16 weeks or more after surgery (treated cohort). These treated patients were matched 1:4 with 852 controls who were never treated for HCV infection (untreated cohort) by age, gender, cirrhosis, and the elapsed time between surgery and antiviral therapy. Cumulative incidences of and hazard ratios for recurrent HCC were calculated after adjusting for competing mortality. The recurrence rate of HCC was significantly lower in the treated than untreated cohort, with 52.1% (95% confidence interval [CI], 42.0-62.2%) and 63.9% (95% CI, 58.9-68.8%) after 5 years of follow-up, respectively (P = 0.001). The number needed to treat for one fewer recurrent HCC at 5 years was 8. The association between postoperative antiviral treatment and risk of recurrent HCC was independent of adjustment for multiple covariates, with an adjusted hazard ratio of 0.64 (95% CI, 0.50-0.83). Stratified analyses revealed that the attenuation in recurrence risk was greater in patients younger than 60 years and those without cirrhosis or diabetes. Conclusion: Postoperative pegylated interferon plus ribavirin is associated with reduced recurrence of HCC in patients with HCV infection. Age, liver cirrhosis, and diabetes mellitus appear to modify this association.
Authors:
Yao-Chun Hsu; Hsiu J Ho; Ming-Shiang Wu; Jaw-Town Lin; Chun-Ying Wu
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2013-05-15
Journal Detail:
Title:  Hepatology (Baltimore, Md.)     Volume:  58     ISSN:  1527-3350     ISO Abbreviation:  Hepatology     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-06-26     Completed Date:  2013-08-30     Revised Date:  2014-05-02    
Medline Journal Info:
Nlm Unique ID:  8302946     Medline TA:  Hepatology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  150-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 American Association for the Study of Liver Diseases.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Carcinoma, Hepatocellular / drug therapy*,  epidemiology,  pathology,  surgery
Chemotherapy, Adjuvant
Cohort Studies
Female
Hepatitis C / complications,  drug therapy*
Humans
Interferon-alpha / therapeutic use*
Liver Neoplasms / drug therapy*,  epidemiology,  pathology,  surgery
Male
Middle Aged
Polyethylene Glycols / therapeutic use*
Postoperative Period
Proportional Hazards Models
Recombinant Proteins / therapeutic use
Recurrence
Ribavirin / therapeutic use*
Taiwan / epidemiology
Chemical
Reg. No./Substance:
0/Interferon-alpha; 0/Polyethylene Glycols; 0/Recombinant Proteins; 0/peginterferon alfa-2a; 49717AWG6K/Ribavirin
Comments/Corrections
Comment In:
Hepatology. 2014 Apr;59(4):1652-3   [PMID:  24038021 ]
Hepatology. 2014 Apr;59(4):1652   [PMID:  23960003 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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