1. ¹Department of Surgery and Clinical Oncology, Graduate School of Medicine, Osaka University, 2-2, Yamadaoka E-2, Suita, Osaka 565-0871, Japan
2. ²Department of Pathology, Osaka City University Hospital, 1-5-7, Asahi-cho Abeno-ku, Osaka 545-0051, Osaka, Japan

Correspondence: Dr H Nagano, E-mail: hnagano@surg2.med.osaka-u.ac.jp

Received 14 February 2005; Revised 1 June 2005; Accepted 13 July 2005; Published online 16 August 2005.

Abstract

We previously reported the beneficial effects of combination therapy of interferon (IFN)-/5-fluorouracil (FU) for advanced hepatocellular carcinoma (HCC) with tumour thrombi in the major portal branches. This report describes the results of longer follow-up and includes more than double the number of patients relative to the original report, and evaluates the role of IFN-/type 2 interferon receptor (IFNAR2) expression on the response to the combination therapy. The study subjects were 55 patients with advanced HCC and tumour thrombi in the major branches of the portal vein (Vp3 or 4). They were treated with at least two courses of IFN-/5-FU without major complication. In the 55 patients, 24 (43.6%) showed objective response (eight (14.5%) showed complete response, 16 (29.1%) partial response), four (7.3%) showed no response, and 27 (49.1%) showed progressive disease. Immunohistochemically, IFNAR2 expression was detected in nine out of 13 (69.2%) patients. There was significant difference in the time-to-progression survival (P=0.0002) and the overall survival (P<0.0001) between IFNAR2-positive and -negative cases. There was a significant correlation between IFNAR2 expression and response to IFN-/5-FU combination therapy in univariate analysis (P=0.0070). IFN-/5-FU combination therapy is a promising modality for advanced HCC with tumour thrombi in the major portal branches and could significantly depend on IFNAR2 expression.