title: Chemoembolization combined with pravastatin improves survival in patients with hepatocellular carcinoma.
abstract: OBJECTIVE
  Pravastatin, a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, has been shown to inhibit growth and to induce apoptosis in human hepatocellular carcinoma (HCC) cells. However, the potential benefit of pravastatin in HCC patients has still not been characterized, which prompted us to test the efficacy of pravastatin in patients with advanced HCC.
  
  
  METHODS
  We investigated prospectively a cohort of 183 HCC patients who had been selected for palliative treatment by transarterial chemoembolization (TACE). Fifty-two patients received TACE combined with pravastatin (20-40 mg/day) and 131 patients received chemoembolization alone. Six independent predictors of survival according to the Vienna survival model for HCC were equally distributed in both groups.
  
  
  RESULTS
  During the observation period of up to 5 years, 31 (23.7%) out of 131 patients treated by TACE alone and 19 (36.5%) out of 52 patients treated by TACE and pravastatin survived. Median survival was significantly longer in HCC patients treated by TACE and pravastatin (20.9 months, 95% CI 15.5-26.3, p = 0.003) than in HCC patients treated by TACE alone (12.0 months, 95% CI 10.3-13.7).
  
  
  CONCLUSIONS
  Combined treatment of chemoembolization and pravastatin improves survival of patients with advanced HCC in comparison to patients receiving chemoembolization alone.
authors.affiliation: Department of Medicine II, Klinikum Grosshadern, Ludwig Maximilian University, Munich, Germany.
authors.forename: Hannah
authors.initials: H
authors.lastname: Graf
authors.forename: Christoph
authors.initials: C
authors.lastname: Jüngst
authors.forename: Gundula
authors.initials: G
authors.lastname: Straub
authors.forename: Selin
authors.initials: S
authors.lastname: Dogan
authors.forename: Ralf-Thorsten
authors.initials: RT
authors.lastname: Hoffmann
authors.forename: Tobias
authors.initials: T
authors.lastname: Jakobs
authors.forename: Maximilian
authors.initials: M
authors.lastname: Reiser
authors.forename: Tobias
authors.initials: T
authors.lastname: Waggershauser
authors.forename: Thomas
authors.initials: T
authors.lastname: Helmberger
authors.forename: Andreas
authors.initials: A
authors.lastname: Walter
authors.forename: Autar
authors.initials: A
authors.lastname: Walli
authors.forename: Dietrich
authors.initials: D
authors.lastname: Seidel
authors.forename: Burkhard
authors.initials: B
authors.lastname: Goke
authors.forename: Dieter
authors.initials: D
authors.lastname: Jüngst
mesh_terms: D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D003131:Combined Modality Therapy; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017035:Pravastatin / Q000627:therapeutic use*; D011446:Prospective Studies
chemical_list: D000903:Antibiotics, Antineoplastic; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D015251:Epirubicin; D017035:Pravastatin