***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND / AIMS Vitamin K2 ( VK2 ) appears to have a potent inhibitory activity for cell growth including HCC cells . We investigated whether VK2 could reduce incidence of tumor recurrence after treatment of HCC . Forty-five patients with cured or possibly cured HCC were r and omly selected , assigning patients to treatment ( n=21 ) or control group ( n=24 ) with r and omization list . METHODOLOGY For the treatment group , forty-five mg of Glakay was given orally every day after therapy for HCC . No patients complained of adverse effects .  Abdominal ultrasonography and dynamic CT were performed at 3-month intervals . Recurrence was confirmed by abdominal angiography . RESULTS Recurrence of HCC occurred in 7 cases ( 33.3 % ) for the treatment group and 12 cases ( 50.0 % ) for the control group during mean observation periods of 19.5 and 16.5 months , respectively . Administration of VK2 was not an independent variable for the recurrence on univariate analysis . Cumulative incidence of HCC recurrence did not differ between the two groups , and the cumulative survival rate tended to be high in treatment group ( p = 0.054 ) . Cox regression analysis revealed that serum albumin concentration alone was an independent factor affecting the recurrence . CONCLUSIONS These findings suggest that VK2 does not appear to prevent recurrence of HCC after curative treatment . Our study is preliminary and large-scale trials are needed to determine whether VK2 is of benefit to decrease the recurrence of HCC BACKGROUND Despite the progression of therapeutic approaches , a high frequency of recurrence is what determines the long-term prognosis of patients with hepatocellular carcinoma ( HCC ) . In this study , the chemopreventive effects of vitamin K2 on the recurrence and survival of patients with HCC after curative therapy were evaluated . METHODS Sixty patients who were diagnosed to be free of HCC after radiofrequency ablation therapy or surgery were r and omly assigned to either the vitamin K2 group ( n = 30 patients ) or the control group ( n = 30 patients ) . All patients were positive for the hepatitis C virus ( HCV ) antibody and hepatitis B surface antigen positive patients were excluded from this study . Patients in the vitamin K2 group received an oral dose of menatetrenone at 45 mg per day . Disease recurrence and the survival rates were analyzed in patients with HCC . RESULTS The cumulative recurrence-free rates in the vitamin K2 group were 92.3 % at 12 months , 48.6 % at 24 months and 38.8 % at 36 months ; and those in the control group were 71.7 % , 35.9 % and 9.9 % , respectively ( P = 0.045 ) . The cumulative survival rates in the vitamin K2 group were 100 % at 12 months , 95.0 % at 24 months and 77.5 % at 36 months ; and those in the control group were 95.8 % , 90.2 % and 66.4 % , respectively ( P = 0.70 ) . CONCLUSIONS Vitamin K2 may have a suppressive effect on the recurrence of HCC and a beneficial effect on tumor recurrence . However , there was no significant difference in the survival rates . The chemopreventive effects of vitamin K2 are not sufficient . The development of a further regimen such as combination therapy is required BACKGROUND Postsurgical recurrence of hepatocellular carcinoma ( HCC ) is frequent and fatal . Adoptive immunotherapy is active against HCC . We assessed whether postoperative immunotherapy could lower the frequency of recurrence . METHODS Between 1992 and 1995 , we did a r and omised trial in which 150 patients who had undergone curative resection for HCC were assigned adoptive immunotherapy  ( n=76 ) or  no adjuvant treatment  ( n=74 ) . Autologous lymphocytes activated vitro with recombinant interleukin-2 and antibody to CD3 were infused five times during the first 6 months . Primary endpoints were time to first recurrence and recurrence-free survival and analyses were by intention to treat . FINDINGS 76 patients received 370 ( 97 % ) of 380 scheduled lymphocyte infusions ( mean cell number per patient 7.1x10(10 ) [ SD 2.1 ] ; CD3 and HLA-DR cells 78 % [ 16 ] ) , and none had grade 3 or 4 adverse events . After a median follow-up of 4.4 years ( range 0.2 - 6.7 ) , adoptive immunotherapy decreased the frequency of recurrence by 18 % compared with controls ( 45 [ 59 % ] vs 57 [ 77 % ] ) [ corrected ] patients . Time to first recurrence in the immunotherapy group was significantly longer than that in the control group ( 48 % [ 37 - 59 ] vs 33 % [ 22 - 43 ] at 3 years , 38 % [ 22 - 54 ] vs 22 % [ 11 - 34 ] at 5 years ; p=0.008 ) . The immunotherapy group had significantly longer recurrence-free survival ( p=0.01 ) and disease-specific survival ( p=0.04 ) than the control group . Overall survival did not differ significantly between groups ( p=0.09 ) . INTERPRETATION Adoptive immunotherapy is a safe , feasible treatment that can lower recurrence and improve recurrence-free outcomes after surgery for HCC CONTEXT Previous findings indicate that vitamin K2 ( menaquinone ) may play a role in controlling cell growth . OBJECTIVE To determine whether vitamin K2 has preventive effects on the development of hepatocellular carcinoma in women with viral cirrhosis of the liver . DESIGN , SETTING , AND PARTICIPANTS Forty women diagnosed as having viral liver cirrhosis were admitted to a university hospital between 1996 and 1998 and were r and omly assigned to the treatment or control group . The original goal of the trial was to assess the long-term effects of vitamin K2 on bone loss in women with viral liver cirrhosis . However , study participants also satisfied criteria required for examination of the effects of such treatment on the development of hepatocellular carcinoma . INTERVENTIONS The treatment group received 45 mg/d of vitamin K2 ( n = 21 ) . Participants in the treatment and control groups received symptomatic therapy to treat ascites , if necessary , and dietary advice . MAIN OUTCOME MEASURE Cumulative proportion of patients with hepatocellular carcinoma . RESULTS Hepatocellular carcinoma was detected in 2 of the 21 women given  vitamin K2 and 9 of the 19 women in the control group . The cumulative proportion of patients with hepatocellular carcinoma was smaller in the treatment group ( log-rank test , P = .02 ) . On univariate analysis , the risk ratio for the development of hepatocellular carcinoma in the treatment group compared with the control group was 0.20 ( 95 % confidence interval [ CI ] , 0.04 - 0.91 ; P = .04 ) . On multivariate analysis with adjustment for age , alanine aminotransferase activity , serum albumin , total bilirubin , platelet count , alpha-fetoprotein , and history of treatment with interferon alfa , the risk ratio for the development of hepatocellular carcinoma in patients given vitamin K2 was 0.13 ( 95 % CI , 0.02 - 0.99 ; P = .05 ) . CONCLUSION There is a possible role for vitamin K2 in the prevention of hepatocellular carcinoma in women with viral cirrhosis Hepatocellular carcinoma ( HCC ) is characterized by frequent recurrence , even after curative treatment . Vitamin K2 , which has been reported to reduce HCC development , may be effective in preventing HCC recurrence . Patients who underwent curative ablation or resection of HCC were r and omly assigned to receive placebo , 45 mg/day , or 90 mg/day vitamin K2 in double‐blind fashion . HCC recurrence was surveyed every 12 weeks with dynamic computed tomography/magnetic resonance imaging , with HCC‐specific tumor markers monitored every 4 weeks . The primary aim was to confirm the superiority of active drug to placebo concerning disease‐free survival ( DFS ) , and the secondary aim was to evaluate dose‐response relationship . Disease occurrence and death from any cause were treated as events . Hazard ratios ( HRs ) for disease occurrence and death were calculated using a Cox proportional hazards model . Enrollment was commenced in March 2004 . DFS was assessed in 548 patients , including 181 in the placebo group , 182 in the 45‐mg/day group , and 185 in the 90‐mg/day group . Disease occurrence or death was diagnosed in 58 , 52 , and 76 patients in the respective groups . The second interim analysis indicated that vitamin K2 did not prevent disease occurrence or death , with an HR of 1.150 ( 95 % confidence interval : 0.843‐1.570 , one‐sided ; P = 0.811 ) between the placebo and combined active‐drug groups , and the study was discontinued in March 2007 
    Output:
    
The VK2 analog may reduce recurrence rate after 1 year and improve OS in HCC patients as early as 1 year .