Outcomes of nontransplant potentially curative therapy for early-stage hepatocellular carcinoma in Child-Pugh stage A cirrhosis is comparable with liver transplantation

• Published in: Digestive diseases (Basel) Vol. 25; no. 4; p. 303
• Main Authors: Takahashi, Shunsuke, Kudo, Masatoshi, Chung, Hobyung, Inoue, Tatsuo, Nagashima, Miki, Kitai, Satoshi, Tatsumi, Chie, Minami, Yasunori, Ueshima, Kazuomi, Fukunaga, Toyokazu, Haji, Seiji
• Format: Journal Article
• Language: English
• Published: Switzerland 01.01.2007
• Subjects: Adult; Aged; Aged, 80 and over; Antiviral Agents - therapeutic use; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - surgery; Catheter Ablation; Female; Humans; Liver Cirrhosis - complications; Liver Cirrhosis - pathology; Liver Neoplasms - drug therapy; Liver Neoplasms - mortality; Liver Neoplasms - surgery; Liver Transplantation; Male; Middle Aged; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - therapy; Prognosis; Regression Analysis; Retrospective Studies; Survival Analysis; Treatment Outcome
• ISSN: 1421-9875
• DOI: 10.1159/000106909

This study was undertaken to assess the outcome of potentially curative therapy for early-stage hepatocellular carcinoma (HCC) in patients with Child-Pugh stage A cirrhosis as well as to investigate the impact of low-dose interferon (IFN) therapy after curative therapy on survival. This study retrospectively evaluated clinical outcomes in a cohort of 224 Child-Pugh stage A cirrhotic patients who received either resection (53 cases) or radiofrequency ablation (RFA: 171 cases) for HCC within Milan criteria. Thirty patients were treated with low-dose maintenance IFN therapy after initial curative therapy. The median follow-up period was 36.7 months. The 5-year survival rate of all patients was 74.9%, with similar rates for the resection and RFA groups (70.4 vs. 76.8%; p = 0.561). The 5-year HCC recurrence rate was higher in the RFA group than the resection group (85.3 vs. 73.2%; p = 0.012). The maintenance IFN-treated group maintained their liver function within Child-Pugh stage A for a significantly longer time (median time 36.9 vs. 32.2 months; p = 0.0025). The 5-year outcomes of resection and RFA in patients with Child-Pugh stage A cirrhosis and early stage HCC were comparable with liver transplantation. Low-dose, long-term maintenance IFN therapy after curative therapy was significantly beneficial on survival.