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Association of perioperative use of statins, metformin, and aspirin with recurrence after curative liver resection in patients with hepatocellular carcinoma: A propensity score matching analysis

BACKGROUND: Statins, metformin, and aspirin have been reported to reduce the incidence of hepatocellular carcinoma (HCC). However, the effect of their perioperative use on survival outcomes of HCC patients following curative liver resection still remains unclear. METHOD: Three hundred and fifty thre...

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Autores principales: Khajeh, Elias, Aminizadeh, Ehsan, Moghadam, Arash Dooghaie, Ramouz, Ali, Klotz, Rosa, Golriz, Mohammad, Merle, Uta, Springfeld, Christoph, Chang, De‐Hua, Longerich, Thomas, Büchler, Markus W., Mehrabi, Arianeb
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10587989/
https://www.ncbi.nlm.nih.gov/pubmed/37737550
http://dx.doi.org/10.1002/cam4.6569
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author Khajeh, Elias
Aminizadeh, Ehsan
Moghadam, Arash Dooghaie
Ramouz, Ali
Klotz, Rosa
Golriz, Mohammad
Merle, Uta
Springfeld, Christoph
Chang, De‐Hua
Longerich, Thomas
Büchler, Markus W.
Mehrabi, Arianeb
author_facet Khajeh, Elias
Aminizadeh, Ehsan
Moghadam, Arash Dooghaie
Ramouz, Ali
Klotz, Rosa
Golriz, Mohammad
Merle, Uta
Springfeld, Christoph
Chang, De‐Hua
Longerich, Thomas
Büchler, Markus W.
Mehrabi, Arianeb
author_sort Khajeh, Elias
collection PubMed
description BACKGROUND: Statins, metformin, and aspirin have been reported to reduce the incidence of hepatocellular carcinoma (HCC). However, the effect of their perioperative use on survival outcomes of HCC patients following curative liver resection still remains unclear. METHOD: Three hundred and fifty three patients with a first diagnosis of HCC who underwent curative liver resection were included. Propensity score matching analysis with a users: nonusers ratio of 1:2 were performed for each of the medications (statins, metformin, and aspirin). Overall survival (OS) and recurrence‐free survival (RFS) were evaluated and multivariable Cox proportional hazard analysis was performed. RESULTS: Sixty two patients received statins, 48 patients used metformin, and 53 patients received aspirin for ≥90 days before surgery. None of the medications improved OS. RFS of statin users was significantly longer than that of nonusers (p = 0.021) in the matched cohort. Users of hydrophilic statins, but not lipophilic ones had a significantly longer RFS than nonusers. Multivariable analysis showed that statin use significantly improved RFS (hazard ratio [HR]: 0.41, 95% confidence interval [CI]: 0.17–0.97, p = 0.044). No difference was seen in RFS between metformin users and nonusers. Among patients with diabetes, RFS was nonsignificantly longer in metformin users than in non‐metformin users (84.1% vs. 60.85%, p = 0.069) in the matched cohort. No difference in postoperative RFS was seen between aspirin users and nonusers. CONCLUSION: Preoperative use of statins in patients with HCC can increase RFS after curative liver resection, but metformin and aspirin were not associated with improved survival. Randomized controlled trials are needed to confirm the findings of the present study.
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spelling pubmed-105879892023-10-21 Association of perioperative use of statins, metformin, and aspirin with recurrence after curative liver resection in patients with hepatocellular carcinoma: A propensity score matching analysis Khajeh, Elias Aminizadeh, Ehsan Moghadam, Arash Dooghaie Ramouz, Ali Klotz, Rosa Golriz, Mohammad Merle, Uta Springfeld, Christoph Chang, De‐Hua Longerich, Thomas Büchler, Markus W. Mehrabi, Arianeb Cancer Med RESEARCH ARTICLES BACKGROUND: Statins, metformin, and aspirin have been reported to reduce the incidence of hepatocellular carcinoma (HCC). However, the effect of their perioperative use on survival outcomes of HCC patients following curative liver resection still remains unclear. METHOD: Three hundred and fifty three patients with a first diagnosis of HCC who underwent curative liver resection were included. Propensity score matching analysis with a users: nonusers ratio of 1:2 were performed for each of the medications (statins, metformin, and aspirin). Overall survival (OS) and recurrence‐free survival (RFS) were evaluated and multivariable Cox proportional hazard analysis was performed. RESULTS: Sixty two patients received statins, 48 patients used metformin, and 53 patients received aspirin for ≥90 days before surgery. None of the medications improved OS. RFS of statin users was significantly longer than that of nonusers (p = 0.021) in the matched cohort. Users of hydrophilic statins, but not lipophilic ones had a significantly longer RFS than nonusers. Multivariable analysis showed that statin use significantly improved RFS (hazard ratio [HR]: 0.41, 95% confidence interval [CI]: 0.17–0.97, p = 0.044). No difference was seen in RFS between metformin users and nonusers. Among patients with diabetes, RFS was nonsignificantly longer in metformin users than in non‐metformin users (84.1% vs. 60.85%, p = 0.069) in the matched cohort. No difference in postoperative RFS was seen between aspirin users and nonusers. CONCLUSION: Preoperative use of statins in patients with HCC can increase RFS after curative liver resection, but metformin and aspirin were not associated with improved survival. Randomized controlled trials are needed to confirm the findings of the present study. John Wiley and Sons Inc. 2023-09-22 /pmc/articles/PMC10587989/ /pubmed/37737550 http://dx.doi.org/10.1002/cam4.6569 Text en © 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle RESEARCH ARTICLES
Khajeh, Elias
Aminizadeh, Ehsan
Moghadam, Arash Dooghaie
Ramouz, Ali
Klotz, Rosa
Golriz, Mohammad
Merle, Uta
Springfeld, Christoph
Chang, De‐Hua
Longerich, Thomas
Büchler, Markus W.
Mehrabi, Arianeb
Association of perioperative use of statins, metformin, and aspirin with recurrence after curative liver resection in patients with hepatocellular carcinoma: A propensity score matching analysis
title Association of perioperative use of statins, metformin, and aspirin with recurrence after curative liver resection in patients with hepatocellular carcinoma: A propensity score matching analysis
title_full Association of perioperative use of statins, metformin, and aspirin with recurrence after curative liver resection in patients with hepatocellular carcinoma: A propensity score matching analysis
title_fullStr Association of perioperative use of statins, metformin, and aspirin with recurrence after curative liver resection in patients with hepatocellular carcinoma: A propensity score matching analysis
title_full_unstemmed Association of perioperative use of statins, metformin, and aspirin with recurrence after curative liver resection in patients with hepatocellular carcinoma: A propensity score matching analysis
title_short Association of perioperative use of statins, metformin, and aspirin with recurrence after curative liver resection in patients with hepatocellular carcinoma: A propensity score matching analysis
title_sort association of perioperative use of statins, metformin, and aspirin with recurrence after curative liver resection in patients with hepatocellular carcinoma: a propensity score matching analysis
topic RESEARCH ARTICLES
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10587989/
https://www.ncbi.nlm.nih.gov/pubmed/37737550
http://dx.doi.org/10.1002/cam4.6569
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