Abstract
Simple SummaryAntiplatelet therapy shows antitumor effect in several types of cancers. In liver disease, antiplatelet therapy reduces liver fibrosis and occurrence of HCC. However, the effect after diagnosis of hepatocellular carcinoma is still unknown. Therefore, we aimed to clarify the effects of antiplatelet therapy for HCC patients in this study. We compared patients with and without antiplatelet therapy in overall survival, liver-related death, tumor progression, Child-Pugh deterioration and bleeding. Our results suggested that antiplatelet therapy had antitumor effect, liver protective effect and safety. Therefore, patients with antiplatelet therapy could reduce liver-related death and improve overall survival.Aims: Antiplatelet therapy has been reported to reduce liver fibrosis and hepatocellular carcinoma (HCC), and has exhibited antitumor properties in other cancers. However, the effects of antiplatelet therapy after diagnosis of HCC are unknown. We investigated the effects of antiplatelet therapy on prognosis, tumor progression, liver function and safety in HCC patients. Methods: We retrospectively analyzed 772 HCC patients. Antiplatelet therapy was defined as the regular intake of aspirin or clopidogrel from HCC diagnosis through to an endpoint of either overall survival (OS) or liver-related death. Overall survival, liver-related death, tumor progression, Child–Pugh deterioration and hemorrhage were analyzed for patients who either had or had not undertaken antiplatelet therapy. Results: The numbers of patients who did and did not undertake antiplatelet therapy were 111 and 661, respectively. Patients who undertook antiplatelet therapy were older and had better liver function at diagnosis. Antiplatelet therapy resulted in significant improvements in OS (p < 0.01) and lower risk of liver-related death (p < 0.01). Multivariate Cox regression analysis revealed that antiplatelet therapy had a significant negative association with liver-related death (hazard ratio (HR): 0.64, 95% confidence interval (CI): 0.44–0.93, p = 0.02). In patients who underwent transcatheter arterial chemoembolization (TACE) as the first treatment, antiplatelet therapy prevented tumor progression (p < 0.01) and Child–Pugh deterioration (p < 0.01). Antiplatelet therapy did not increase the risk of hemorrhagic events. Conclusions: Antiplatelet therapy reduced liver-related death and improved OS safely in HCC patients.
Highlights
Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related death worldwide [1]
We investigated the effect of antiplatelet therapy on the prognoses of hepatocellular carcinoma (HCC) patients, focusing on HCC recurrence and deterioration of liver function
We evaluated the eligibility of 784 patients with HCC, and 772 were subsequently included in this study
Summary
Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related death worldwide [1]. Cancers 2020, 12, 3215 chemoembolization (TACE) and tyrosine kinase inhibitor (TKI) have become the standard options for HCC treatment. Prognosis in HCC remains unsatisfactory because of a high recurrence rate and deterioration of liver function after treatment [2]. Antiplatelet therapy had been shown to prevent liver fibrosis and the occurrence of HCC [3,4,5,6,7]. Several mechanisms have been proposed to explain the protective effects. The anti-inflammatory action of antiplatelet agents inhibits transcription of nuclear factor-kappa
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