The use of β-blockers is associated with a lower risk of developing hepatocellular carcinoma in patients with cirrhosis.
BACKGROUND
Patients with cirrhosis by hepatitis C virus infection treated with β-blockers (BB) have been shown to have a reduced incidence of hepatocellular carcinoma (HCC). Also, an association between propranolol therapy and lower incidence of other tumors has been described.


OBJECTIVE
To analyze the incidence of HCC according to BB treatment in cirrhosis of any cause.


METHODS
Cirrhotic patients included in the program for early detection of HCC were followed. Patients' data were prospectively registered, including transplantation and death. Patients were classified as chronically taken or not BB and the proportions of patients who remained free of tumor from the diagnosis of cirrhosis until the end of follow-up were compared using Kaplan-Meier analysis and the Breslow test.


RESULTS
A total of 173 patients (73 treated and 100 untreated BB) were followed. The median duration of follow-up was 11 years. There were no differences between both groups in the overall survival, number of deaths, or liver transplant.Overall, 28 patients developed HCC during the follow-up, 20 patients who were untreated and eight patients treated with BB. The cumulative proportion of cases of HCC between untreated and treated with BB from the diagnosis of cirrhosis was statistically significant (6 vs. 3%, at 5 years; 19 vs. 6% at 10 years; 24 vs. 16% at 15 years; P=0.048). Multivariate analyses showed BB intake as the only significant variable associated with the development of HCC.


CONCLUSIONS
Cirrhotic patients treated with BB have a lower cumulative probability of developing HCC during the 10 years after the diagnosis of cirrhosis.
aCIBERehd bLiver Unit, Gastroenterology Department cClinic Pharmacology Unit, Hospital General Universitario de Alicante dUniversity Miguel Hernández, Alicante, Spain.
Iván
I
Herrera
Sonia
S
Pascual
Pedro
P
Zapater
Fernando
F
Carnicer
Pablo
P
Bellot
José
J
María Palazón
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D016009:Chi-Square Distribution; D005260:Female; D006526:Hepatitis C / Q000453:epidemiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D065840:Protective Factors; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists