Statins improve outcomes of nonsurgical curative treatments in hepatocellular carcinoma patients.
Statins are associated with a reduced risk of hepatocellular carcinoma (HCC) and have the potential to be an adjuvant agent for HCC. In this study, we examined whether statin use is associated with additional benefits among patients who received curative treatments (CTs) such as surgery, percutaneous ethanol injection (PEI), and radiofrequency ablation (RFA).We conducted a cohort study using the Taiwan National Health Insurance Research Data linked to the Taiwan Cancer Registry in 2001 to 2012. The patient cohort consisted of those who received different treatments, and we compared patients who received statins with those who did not. Statin users were defined as patients who received >28 cumulative defined daily doses after their HCC diagnosis. We used a time-dependent Cox proportional method to model the time from the HCC diagnosis to any death and HCC death between men who received statins and those who did not after adjusting for confounders. Data on statin prescriptions were collected every 6 months to define the user status.In total, 18,892 patients were included, and the mean follow-up duration was 1.74 years. The adjusted hazard ratio (aHR) of all-cause deaths increased in HCC patients who received RFA/PEI compared to those who received surgery (P < 0.0001 and P < 0.05, with aHRs of 1.81 and 1.16, respectively, for hepatitis B virus [HBV] or non-HBV HCC). However, with the addition of statin use to RFA or PEI, the overall survival was statistically equal.Surgical resection is still superior over other therapies. If HCC patients cannot meet the criteria for surgery, the addition of statin use to RFA or PEI might improve HCC survival.
Department of Ophthalmology, National Taiwan University Hospital, Taipei Department of Ophthalmology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei Department of General Surgery Department of Hemato-Oncology, Wan Fang Hospital, Taipei Medical University Institute of Toxicology, College of Medicine, National Taiwan University Department of Radiation Oncology, Wan Fang Hospital Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei Department of Biotechnology, Hungkuang University, Taichung, Taiwan.
Li-Li
LL
Wu
Mao-Chih
MC
Hsieh
Jyh-Ming
JM
Chow
Shing-Hwa
SH
Liu
Chia-Lun
CL
Chang
Szu-Yuan
SY
Wu
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D017115:Catheter Ablation; D015331:Cohort Studies; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012997:Solvents / Q000008:administration & dosage*; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D012997:Solvents; D000431:Ethanol