Six RCTs (n=600 patients) were included in the review. The mean length of follow-up ranged from 27 to 85 months.
Early recurrence: Early recurrence was lower after interferon-alpha treatment (OR 0.62, 95% CI 0.42 to 0.93; five RCTs); there was no evidence of statistical heterogeneity (p=0.77). Early recurrence was also lower with interferon-alpha treatment after resection only (OR 0.58, 95% CI 0.37 to 0.91; three RCTs), after resection without pre-resection ablation therapy (results not reported), and from repeating analyses using random-effects models.
Survival: Survival at one year was improved with interferon-alpha treatment (OR 3.14 95% CI 1.79 to 5.52; five RCTs), there was no evidence of statistical heterogeneity (p=0.59). Similar results were seen after resection only (OR 3.19, 95% CI 1.80 to 5.67; four RCTs), after resection without pre-resection ablation therapy (OR 3.83, 95% CI 2.01 to 7.27; three RCTs) and from repeating analyses using random-effects models.
There was no evidence of any publication bias for either outcome.