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Association between statin use and the prognosis of hepatocellular carcinoma after resection: a nationwide cohort study.
Jeon, Dongsub; Cha, Hye Ryeong; Chung, Sung Won; Choi, Jonggi; Lee, Danbi; Shim, Ju Hyun; Kim, Kang Mo; Lim, Young-Suk; Lee, Han Chu; Lee, Seung Won; Choi, Won-Mook.
Afiliación
  • Jeon D; Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
  • Cha HR; Department of Computer Science and Engineering, Sungkyunkwan University, Suwon, Gyeonggi-do, Republic of Korea.
  • Chung SW; Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
  • Choi J; Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
  • Lee D; Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
  • Shim JH; Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
  • Kim KM; Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
  • Lim YS; Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
  • Lee HC; Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
  • Lee SW; Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, Gyeonggi-do, Republic of Korea.
  • Choi WM; Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
EClinicalMedicine ; 65: 102300, 2023 Nov.
Article en En | MEDLINE | ID: mdl-37965429
ABSTRACT

Background:

The majority of patients with hepatocellular carcinoma (HCC) following hepatic resection experience tumor recurrence. Statin use is associated with a reduced risk of HCC development; however, the association between statin use and the prognosis of HCC after resection remains unclear. We aimed to investigate the effect of statin use on the prognosis after hepatic resection among patients with HCC.

Methods:

A nationwide cohort study was performed with data from the National Health Insurance Service Database in Korea. Among 65,101 HCC patients who underwent hepatic resection between January 2002 and December 2017, we included 21,470 patients. For validation, a hospital-based cohort of 3366 patients with very early or early-stage HCC who received curative-intent hepatic resection between January 2010 and December 2018 was analyzed. Recurrence-free survival (RFS) and overall survival (OS) was compared between statin users and non-users.

Findings:

Among the nationwide cohort of 21,470 patients, 2399 (11.2%) used statins and 19,071 (88.8%) did not. Among the hospital cohort of 3366 patients, 363 (10.8%) used statins and 3003 (89.2%) did not. In the propensity score-matched nationwide cohort, statin users had better RFS (hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.56-0.64; P < 0.001) and OS (HR, 0.49; 95% CI, 0.45-0.53; P < 0.001), with a duration-response relationship. In the propensity score-matched validation hospital cohort, statin treatment was significantly associated with better RFS (HR, 0.73; 95% CI, 0.59-0.90; P = 0.003) and OS (HR, 0.48; 95% CI, 0.32-0.72; P < 0.001). The beneficial effects of statins were more prominent in non-cirrhotics, tumors sized ≥3 cm, tumors with microscopic vascular invasion, or early HCC recurrence (<2 years after resection).

Interpretation:

Statin use was associated with a better prognosis in a population-based cohort of patients with HCC after hepatic resection, which was further validated in a large hospital-based cohort.

Funding:

Asan Institute for Life Sciences and Corporate Relations; Korean Association for the Study of the Liver.
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Texto completo: 1 Colección: 01-internacional Idioma: En Revista: EClinicalMedicine Año: 2023 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Idioma: En Revista: EClinicalMedicine Año: 2023 Tipo del documento: Article