***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: Lamivudine is widely used to treat patients with hepatitis B. However , the outcomes in patients with hepatocellular carcinoma ( HCC ) treated with lamivudine have not been established . This study was conducted to evaluate the outcomes of lamivudine treatment for patients with HCC using an untreated , matched control group . Thirty patients with controlled HCC orally received lamivudine . As controls , 40 patients with HCC who were not treated with lamivudine and matched for clinical features were selected . The lamivudine-treated and untreated groups were compared with respect to changes in liver function , HCC recurrence , survival , and cause of death . In the lamivudine-treated group , there was significant improvement in the Child-Pugh score at 24 months after starting treatment , while no improvement was observed in the untreated group . There was no significant difference in the cumulative incidence of HCC recurrence and survival between the groups . However , there was a significant difference in the cumulative incidence of death due to liver failure ( P= 0.043 ) . A significant improvement in liver function was achieved by lamivudine treatment , even in patients with HCC . These results suggest that lamivudine treatment for patients with HCC may prevent death due to liver failure . Further prospect i ve r and omized studies using a larger number of patients are required BACKGROUND / AIMS Recurrence after resection of hepatocellular carcinoma ( HCC ) is a frequent event . This study evaluated the effect of postoperative interferon alpha ( IFN alpha ) treatment on recurrence and survival in patients with hepatitis B virus (HBV)-related HCC . METHOD Two hundred and thirty six patients were r and omized after resection into IFN alpha treatment ( 5 micro i.m . tiw for 18 months ) and control groups . Treatment was terminated if recurrence was diagnosed , and recurrence was managed the same way in both groups . Statistical analysis was based on the method of intent-to-treat . RESULTS The two groups were comparable in all clinicopathological parameters . The median overall survival was 63.8 months in the treatment group and 38.8 months in the control group ( P=0.0003 ) ; the median disease-free survival period was 31.2 versus 17.7 months ( P=0.142 ) . Fever , leucocytopenia , and thrombocytopenia were adverse effects in the treatment group , but were mostly manageable . CONCLUSIONS IFN alpha treatment improved the overall survival of patients with HBV-related HCC after curative resection , probably by postponing recurrence Objective : We conducted a r and omized controlled trial of adjuvant interferon therapy in patients with predominantly hepatitis B-related hepatocellular carcinoma ( HCC ) to investigate whether the prognosis after hepatic resection could be improved . Summary Background Data : Recurrence is common after hepatic resection for HCC . Interferon possesses antiviral , immunomodulatory , antiproliferative , and antiangiogenic effects and may be an effective form of adjuvant therapy . Patients and Methods : Since February 1999 , patients with no residual disease after hepatic resection for HCC were r and omly assigned with stratification by pTNM stage to receive no treatment ( control group ) , interferon alpha-2b 10 MIU/m2 ( IFN-I group ) or 30 MIU/m2 ( IFN-II group ) thrice weekly for 16 weeks . Enrollment to the IFN-II group was terminated from January 2000 because adverse effects result ed in treatment discontinuation in the first 6 patients . By June 2002 , 40 patients each had been enrolled into the control group and IFN-I group . The baseline clinical , laboratory , and tumor characteristics of both groups were comparable . Results : The 1- and 5-year survival rates were 85 % and 61 % , respectively , for the control group and 97 % and 79 % , respectively , for the IFN-I group ( P = 0.137 ) . After adjusting for the confounding prognostic factors in a Cox model , the relative risk of death for interferon treatment was 0.42 ( 95 % CI , 0.17–1.05 ; P = 0.063 ) . Exploratory subset analysis showed that adjuvant interferon had no survival benefit for pTNM stage I/II tumor ( 5-year survival 90 % in both groups ; P = 0.917 ) but prevented early recurrence and improved the 5-year survival of patients with stage III/IVA tumor from 24 % to 68 % ( P = 0.038 ) . Conclusion : In a group of patients with predominantly hepatitis B-related HCC , adjuvant interferon therapy showed a trend for survival benefit , primarily in those with pTNM stage III/IVA tumors . Further larger r and omized trials stratified for stage are needed OBJECTIVE The authors report on the surgical techniques and protocol for perioperative care that have yielded a zero hospital mortality rate in 110 consecutive patients undergoing hepatectomy for hepatocellular carcinoma ( HCC ) . The hepatectomy results are analyzed with the aim of further reducing the postoperative morbidity rate . SUMMARY BACKGROUND DATA In recent years , hepatectomy has been performed with a mortality rate of < 10 % in patients with HCC , but a zero hospital mortality rate in a large patient series has never been reported . At Queen Mary Hospital , Hong Kong , the surgical techniques and perioperative management in hepatectomy for HCC have evolved yearly into a final st and ardized protocol that reduced the hospital mortality rate from 28 % in 1989 to 0 % in 1996 and 1997 . METHODS Surgical techniques were design ed to reduce intraoperative blood loss , blood transfusion , and ischemic injury to the liver remnant in hepatectomy . Postoperative care was focused on preservation and promotion of liver function by providing adequate tissue oxygenation and immediate postoperative nutritional support that consisted of branched-chain amino acid-enriched solution , low-dose dextrose , medium-chain triglycerides , and phosphate . The pre- , intra- , and postoperative data were collected prospect ively and analyzed each year to assess the influence of the evolving surgical techniques and perioperative care on outcome . RESULTS Of 330 patients undergoing hepatectomy for HCC , underlying cirrhosis and chronic hepatitis were present in 161 ( 49 % ) and 108 ( 33 % ) patients , respectively . There were no significant changes in the patient characteristics throughout the 9-year period , but there were significant reductions in intraoperative blood loss and blood transfusion requirements . From 1994 to 1997 , the median blood transfusion requirement was 0 ml , and 64 % of the patients did not require a blood transfusion . The postoperative morbidity rate remained the same throughout the study period . Complications in the patients operated on during 1996 and 1997 were primarily wound infections ; the potentially fatal complications seen in the early years , such as subphrenic sepsis , biliary leakage , and hepatic coma , were absent . By univariate analysis , the volume of blood loss , volume of blood transfusions , and operation time were correlated positively with postoperative morbidity rates in 1996 and 1997 . Stepwise logistic regression analysis revealed that the operation time was the only parameter that correlated significantly with the postoperative morbidity rate . CONCLUSION With appropriate surgical techniques and perioperative management to preserve function of the liver remnant , hepatectomy for HCC can be performed without hospital deaths . To improve surgical outcome further , strategies to reduce the operation time are being investigated Hepatocellular carcinoma ( HCC ) recurrence after ablation therapy for primary tumors is common Background The role of antiviral therapy for patients in the immune-active phase of hepatitis B virus ( HBV ) infection who underwent partial hepatectomy for hepatocellular carcinoma ( HCC ) is unknown . Methods From January 2004 to June 2007 , a nonr and omized comparative study for postoperative antiviral treatment was conducted on patients who underwent curative hepatectomy for advanced HCC . Patients in the treatment group ( n = 43 ) received lamivudine with or without adefovir dipivoxil , while the control group ( n = 36 ) received no antiviral treatment . Results The treatment group had a significantly higher HBeAg seroconversion rate ( 57.2 % vs. 5.6 % ) and a higher HBV DNA suppression rate ( 87.2 % vs. 2.8 % ) after 12 months of antiviral treatment . The treatment group also had a significantly greater increase in residual liver volume per unit surface area following hepatectomy ( 78.0 ± 40.1 cm3/m2 vs. 35.8 ± 56.0 cm3/m2 ) at 6-month postoperation . After a median follow-up of 12 months , there was no significant difference in recurrence rate after surgery between the treatment group and the control group ( 76.7 % and 91.7 % ) . There was a significant difference in the overall survival rate but not in the disease-free survival rate . The 1- and 2-year overall survival rates were 41.9 % and 7.0 % , respectively , for the treatment group , and 33.3 % and 0 % , respectively , for the control group . The 1- and 2-year disease-free survival rates were 23.3 % and 2.3 % , respectively , for the treatment group , and 8.3 % and 0 % , respectively , for the control group . Conclusion Although nucleoside analogs did not reduce short-term recurrence rate , they promoted postoperative viral clearance and increased residual liver volume , which significantly enhanced tolerance to subsequent therapy for disease recurrence BACKGROUND AND AIMS The present study was carried out to test the hypothesis that interferon-alpha ( IFN-alpha ) treatment would reduce or postpone the recurrence rate and improve the overall survival rate in patients after transarterial chemoembolization ( TACE ) treatment of hepatitis B virus ( HBV ) related unresectable hepatocellular carcinoma ( HCC ) . METHODS 216 patients with unresectable HBV-related HCC were r and omized into a TACE group and a  TACE-IFN group , each group had 108 patients . In the TACE-IFN group , patients received IFN-alpha1b at a dose of 3 million units ( mu ) three times a week by intramuscular injection one week after/before TACE treatment , for 48 weeks . RESULTS The median disease-free survival in the TACE-IFN treatment group was 23.6 months ( 95 % CI : 21.4 - 25.8 ) and 20.3 months ( 95 % CI : 15.8 - 24.8 ) in the TACE group ( P = 0.027 ) . The disease free rate at 24 months in the TACE group was lower than in the TACE-IFN group ( 39.8 % vs 59.3 % , P = 0.004 ) . The median overall survival was 29 months ( 95 % CI : 27.5 - 32.1 ) in the TACE-IFN group and 26 months ( 95 % CI : 20.1 - 31.9 ) in the TACE group ( P = 0.003 ) . The 2-year overall survival in the TACE-IFN group was higher than in the TACE group ( 72.2 % vs 52.8 % , P = 0.003 ) . CONCLUSIONS IFN-alpha treatment reduced recurrence and improved the survival of patients after TACE treatment of HBV-related HCC , with acceptable toxicities BACKGROUND Long-term survival after  hepatectomy  for hepatocellular carcinoma is still poor because of tumor recurrence especially in the liver remnant . The risk factors for intrahepatic recurrence after liver resection are studied in our cohort of patients . METHODS A retrospective analysis from a prospect i ve data base was performed on 76 consecutive successful hepatectomies for hepatocellular carcinoma . RESULTS Twenty-two patients had intrahepatic recurrence . The following were not found to be risk factors for recurrence : age , sex , race , number of segments resected , and mean operating time . By using multivariate analysis , serum aspartate transaminase level , more than 1 hepatocellular carcinoma nodule , and presence of tumor thrombi were found to be significant risk factors . CONCLUSION Patients who with these risk factors should undergo close follow-up to detect recurrence early ; treatment with reresection , chemoembolization , or radiofrequency ablation can be considered Objective : To investigate the clinical efficacy of adjuvant interferon alfa-2b ( IFN&agr;-2b ) therapy on recurrence-free survival ( RFS ) of patients with postoperative viral hepatitis-related hepatocellular carcinoma ( HCC ) . Background : Despite most individual trials have failed to meet their primary endpoint , recent pooled- data meta-analyses suggest that adjuvant IFN therapy may significantly reduce the incidence of recurrence in curatively ablated HCC . Methods : Patients with curative resection of viral hepatitis-related HCC were eligible , and were stratified by underlying viral etiology and r and omly allocated to receive either 53 weeks of adjuvant IFN&agr;-2b treatment or observation alone . The primary endpoint of this study was RFS . Results : A total of 268 patients were enrolled with 133 in the IFN&agr;-2b arm and 13 
    Output:
    
Conclusions Adjuvant IFN therapy may significantly reduced mortality as well as recurrence rate of patients with HBV-related HCC after no matter what the previous treatment .
On the other h and , there is no statistical significance on the recurrence rate and mortality after surgical resection only .