Available literature on the benefit of interferon alpha (IFN-a) 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-a on recurrence and survival after complete resection or ablation of hepatocellular carcinoma. All randomized controlled trials comparing IFN-a 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-a 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-a significantly decreased postsurgical or ablative overall early recurrence (OR 5 0.62; 95% CI 5 0.42-0.93; p 5 0.02) and improved overall 1 year survival (OR 5 3.14; 95% CI 5 1.79-5.52; p < 0.0001). Subgroup analyses show that IFN-a decreased postsurgical early recurrence (OR 5 0.58; 95% CI 5 0.37-0.91; p 5 0.02) and improved 1 year survival (OR 5 3.19; 95% CI 5 1.80-5.67; p < 0.0001) evidently. Subgroup analyses also show that IFN-a reduced early recurrence after resection without pre-resection ablation therapy (OR 5 0.58; 95% CI 5 0.37-0.91; p 5 0.02) and improved 1 year survival (OR 5 3.83; 95% CI 5 2.01-7.27; p < 0.0001). These results suggest that IFN-a 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-a as adjuvant postsurgical or ablative treatment seems promising but requires further study. '
UICCKey words: hepatocellular carcinoma; IFN-a; recurrence; survival; resection; ablation Hepatocellular carcinoma (HCC) is one of the most common and aggressive malignant tumors in Asia and Africa, and it is a significant cause of death in eastern Asia and sub-Saharan Africa. 1,2 Because most patients with HCC are diagnosed at intermediate to advanced stages and there is no standard treatment for these patients, only a minority of patients are eligible for potentially curative treatments. 3,4 Among curative treatments, liver transplantation is a good choice for both HCC and the underlying cirrhosis, which theoretically eliminates both the tumor as well as the underlying liver disease; but it can only be performed on a small proportion of patients due to graft availability, selection criteria, high cost, etc. 5,6 Thus, liver resection or perhaps tumor ablation remains the only available curative treatment in many situations. 5 Liver resection is still considered as the first-line therapeutic option for most patients with HCC, and it is regarded as a standard treatment that can offer an opportunity of cure for patients with localized tumors and preserved liver function. 7,8 Besides, currently local ablat...