The effect of retreatment with interferon-alpha on the incidence of hepatocellular carcinoma in patients with chronic hepatitis C

BACKGROUND. Interferon (IFN) has been reported to have beneficial long term effects that reduce the occurrence of hepatocellular carcinoma (I-ICC), ev en in patients who do not have complete responses to IFN. The authors evalu ated the effect of retreatment with IFN-alpha on the long term prognoses of chose with incomplete responses to their initial IFN-alpha treatment. METHODS. Among 271 patients with incomplete responses to initial IFN-alpha treatment who had received sufficient dose and duration (a total dose of mo re than 350 megaunits administered over a period longer than 12 weeks) betw een October 1989 and September 1997, 63 patients received retreatment and 2 08 did not. The authors retrospectively compared the incidence of HCC betwe en patients who received retreatment and those who did not. RESULTS. There were no significant differences in the clinical characterist ics between these two groups. The cumulative incidence of HCC was significa ntly lower among the patients who had retreatment, and retreatment with IFN -alpha was the only factor that correlated with the lower incidence of HCC in multivariate analysis. The results were similar when the 12 patients wit h complete responses to retreatment were excluded from the analysis. CONCLUSIONS. Retreatment with IFN-alpha appeared to have the additional eff ect of suppressing the development of HCC in patients who had incomplete re sponses to the initial treatment, even when the hepatitis C virus was not c leared (i.e., a complete response was not achieved) with retreatment. Furth er prospective study is required. Cancer 2000;88:58-65. (C) 2000 American C ancer Society.