Efficacy of adjuvant interferon-alpha therapy following curative resection in renal cell carcinoma: Before the molecular targeting therapy era

Abstract

Objective: Although present treatment programs for renal cell carcinoma (RCC) typically involve molecular-targeting drugs, interferon-alpha (IFN-α) remains an important therapeutic drug for this cancer. Methods: We evaluated the effect of adjuvant therapy in 508 patients with RCC following curative surgery. Patients were classified into one of the two categories based on the duration and the total dose of IFN-α treatment. Results: Median follow-up time was 65.5 months. Overall survival rates at 5, 10, 15 and 20 years were 88.8%, 80.5%, 69.6% and 54.1%, respectively. Cause-specific survival rates at 5, 10, 15 and 20 years were 95.0%, 89.1%, 83.0% and 83.0%, respectively. Cox's proportional hazard model revealed that C-reactive protein, T classification, histological grade and age were significantly independent factors indicative of a poor prognosis. Our examination of the 253 patients diagnosed as pT1-2N0M0 who underwent adjuvant IFN-α therapy following surgery found that the therapy was not significantly associated with either cause-specific or disease-free survival. With regard to effects of duration of therapy and total dose of IFN-α, patients with a total IFN-α exposure of ≥180 × 106 international units (IU) had a better prognosis than those exposed to <180 × 106 IU. Conclusions: Adjuvant therapy using large doses of IFN-α may improve the prognosis of patients with RCC following curative resection, and the new possibility of IFN-α therapy merits further investigation. © The Author (2009). Published by Oxford University Press. All rights reserved.