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Antiplatelet Therapy is Associated with a Better Prognosis for Patients with Hepatitis B Virus-Related Hepatocellular Carcinoma after Liver Resection.
Lee, Pei-Chang; Yeh, Chiu-Mei; Hu, Yu-Wen; Chen, Chun-Chia; Liu, Chia-Jen; Su, Chien-Wei; Huo, Teh-Ia; Huang, Yi-Hsiang; Chao, Yee; Chen, Tzeng-Ji; Lin, Han-Chieh; Wu, Jaw-Ching.
Afiliação
  • Lee PC; Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan.
  • Yeh CM; Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.
  • Hu YW; Division of Gastroenterology and Hepatology, Department of Medicine, Yuanshan Branch, Taipei Veterans General Hospital, Yilan, Taiwan.
  • Chen CC; Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Liu CJ; Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.
  • Su CW; Cancer Center, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Huo TI; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
  • Huang YH; Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.
  • Chao Y; Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Chen TJ; Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan. chiajenliu@gmail.com.
  • Lin HC; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan. chiajenliu@gmail.com.
  • Wu JC; Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. chiajenliu@gmail.com.
Ann Surg Oncol ; 23(Suppl 5): 874-883, 2016 12.
Article em En | MEDLINE | ID: mdl-27541812
BACKGROUND: Recurrence of hepatocellular carcinoma (HCC) with unsatisfactory survival is common after surgical resection. Antiplatelet therapy with aspirin or clopidogrel was recently shown to prevent hepatic carcinogenesis in a murine model, but its effect in humans had not been clarified. This study aimed to investigate the association between antiplatelet therapy and the outcomes for patients with hepatitis B virus (HBV)-related HCC after liver resection. METHODS: By analyzing data from the Taiwan National Health Insurance Research Database, 9461 HBV-related HCC patients who had undergone liver resection between January 1997 and December 2011 were identified. After one-to-four matching by sex, age, and propensity score, 442 patients with antiplatelet therapy and 1768 patients without antiplatelet therapy were enrolled for the analysis. The Kaplan-Meier method and modified Cox proportional hazards models were used for survival and multivariable, stratified analyses. RESULTS: Recurrence-free survival and overall survival after resection surgery were significantly better after 5 years in the treated cohort than in the untreated cohort (52.8 vs 47.9 %; p = 0.021 and 80.3 vs 65.4 %; p < 0.001, respectively). Besides, antiplatelet therapy reduced the risk of HCC recurrence (hazard ratio [HR] 0.73; p < 0.001) and overall mortality (HR 0.57; p < 0.001) in the multivariable analysis. However, antiplatelet use significantly increased the risk of upper gastrointestinal bleeding (odds ratio [OR] 1.91; p < 0.001). CONCLUSIONS: Use of aspirin or clopidogrel was associated with better recurrence-free survival and overall survival among patients with HBV-related HCC after liver resection. However, these agents should be used with caution due to the adverse effects of upper gastrointestinal bleeding.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Inibidores da Agregação Plaquetária / Carcinoma Hepatocelular / Hemorragia Gastrointestinal / Neoplasias Hepáticas / Recidiva Local de Neoplasia Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: Asia Idioma: En Ano de publicação: 2016 Tipo de documento: Article
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Inibidores da Agregação Plaquetária / Carcinoma Hepatocelular / Hemorragia Gastrointestinal / Neoplasias Hepáticas / Recidiva Local de Neoplasia Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: Asia Idioma: En Ano de publicação: 2016 Tipo de documento: Article